The Let's Move! Campaign, initiated by First Lady Michelle Obama, is an inclusive, wide-ranging program that was designed to help battle the problem of childhood obesity by embracing a number of different approaches. Guidelines within the program are directed towards not only parents and caregivers, but also towards schools, community leaders, elected officials, health care providers, and private sector companies, outlining roles that each can play to improve the health and future well-being of the nation's youth. The campaign provides helpful tips and strategies that

• Encourage parents to set a good example for their children by modeling a healthy diet and participating in regular physical activity;

• Encourage schools to create a healthy learning environment for children and youth, and to incorporate nutrition and physical education into the school day;

• Urge community leaders to initiate and coordinate activities that promote healthy living; and

• Aim directives at elected officials, health care providers, and food prep professionals that address the roles that they can play in reducing childhood obesity.

"5-2-1-0" Strategy

Strategies such as 5-2-1-0, based on existing guidelines (e.g., USDA MyPlate, physical activity guidelines, and sedentary behavior guidelines), support the ideas, philosophies, and goals within the Let's Move! Campaign. Such strategies establish guidelines for specific evidence-based practices that help to reduce the prevalence of childhood obesity, including healthy eating, physical activity, and reducing "screen time." Specifically, the 5-2-1-0 strategy promotes the following daily goals for youth:

• greater than five servings of fruits and vegetables

• less than two hours of screen time

• more than one hour of moderate-to-vigorous physical activity

• zero sugar-sweetened drinks each day

Among civilian communities across the nation that have put the 5-2-1-0 strategy into practice, children have reported adopting healthier lifestyle habits.

Similar to civilian families, service members and their families are not immune to the unhealthy environments (e.g., increased access to unhealthy foods and recreation options that promote sedentary behaviors) in which they live. Moreover, it has been reported that approximately 25-35 percent of military youth will enlist in a branch of the Service as adults (Department of Defense Youth Polls, 2010); therefore, raising healthy and fit children to become healthy and fit adults is essential to building a strong military.

Department of Defense Instruction 6060.02

In response, the Department of Defense (DoD) is working to adopt evidence-based practices to combat and prevent obesity among service members and their families by implementing the following policies and procedures for children, ages birth to twelve years, within DoD Child Development Programs (CDPs), as outlined in DoD Instruction (DoDI) 6060.02:

• Staff orientation of CDP direct care personnel and Family Child Care (FCC) providers must include information regarding nutrition, obesity prevention, and meal service.

• Child Development Centers (CDC) and School Age Care (SAC) programs educate families on how to increase physical activity, improve nutrition, and reduce screen time (e.g., TV, video games, and computer).

• CDC and SAC programs provide information to parents to ensure that each child has a routine health assessment by the child's primary care provider.

• Age-appropriate nutrition education activities are included in the curricula of learning activities and interactions with children.

• On-installation programs (e.g., CDC, SAC, and Youth Centers) use gardens to educate children about healthy eating.

• Written menus are developed and approved by a nutritionist or registered dietician which show all foods to be served during a month, and menus are available to parents and guardians.

• Dietary modifications are made on the basis of recommendations by the child's primary care provider.

• On-installation programming provides healthy meals and snacks that include restrictions on the provision of juice and beverages with added sweeteners and no fried, high-fat, or highly salted foods.

• Breastfeeding is encouraged, supported, and arrangements are provided to make it feasible for mothers and infants.

• Programs provide an opportunity for physical activity on a daily basis as part of providing a developmentally-appropriate environment.

I Am Moving, I Am Learning Program

In addition, I Am Moving, I Am Learning (IMIL) program is a proactive approach used among Head Start pre-school aged children, and comprised of the 5-2-1-0 strategies. This program is gaining momentum in reaching a broader contingent of early childhood professionals. Specifically, the overarching goals of IMIL are to

• Increase the quantity of time spent in moderate-to-vigorous physical activity during daily routines to meet the national guidelines for physical activity.

• Improve the quality of structured movement experiences intentionally facilitated by adults.

• Promote everyday healthy nutrition choices.

A collaborative effort between the Military Services, the DoD, and its land grant university partner, the University of Nebraska - Lincoln, brings together a cadre of early care and education professionals to a regional IMIL 'Train the Trainers' workshop. This joint approach will increase the cadre of trainers available to child care providers within military child development programs.

Clearinghouse for Military Family Readiness

Further, the DoD, and specifically, the Office of the Deputy Assistant Secretary of Defense for Military Community and Family Policy, has partnered with The Pennsylvania State University to develop the Clearinghouse for Military Family Readiness. Within the Clearinghouse, the Resource Center for the Prevention of Military Child Obesity was developed as part of the strategic plan to support the DoD's commitment to addressing the obesity epidemic in America.

The DoD's Child Obesity Work Group tasked the Clearinghouse's Resource Center with identifying evidence-based programs and services that employ strategies like those described above within 5-2-1-0. Through this research, the Clearinghouse is infusing empirical evidence into the military's efforts to prevent childhood obesity. Further, the Resource Center is an interactive, searchable, web-based platform developed for professionals to more effectively address child obesity as well as obesity among the military families they serve.

Thus far, the Clearinghouse's Resource Center team has reviewed the evidence of more than 100 programs and services related to the prevention or treatment of obesity in children and adults. Staff members review program materials, including websites, curricula, and both peer-reviewed and non-peer reviewed research evaluating its effectiveness. Using only peer-reviewed, published data, programs are placed in the appropriate category on the Clearinghouse's Continuum of Evidence. Fact sheets are also developed for each program and can be found on the Clearinghouse website. The Clearinghouse's Resource Center will continue to expand its database in the coming months and will serve as a resource for those working to prevent and treat childhood obesity in military families.

Next Steps

The DoD's next steps to lead the way in addressing this nation-wide epidemic involve the documentation, tracking, and evaluation of its efforts to decrease the prevalence of childhood obesity. At a population level, this should include monitoring children's weight and risk factors for negative health outcomes. More extensive resources are needed for the evaluation of the effects of individual programs and combinations of environmental, policy, and education interventions.