Swot Analysis Paper

CHILDHOOD OBESITY: HOW BIG CAN IT GET

Table of Contents
INTRODUCTION…………………………………………………………………….p. 3
CURRENT ASSESSMENT...................................................................................p. 4
STRUCTURE AND CURRENT STATE OF THE SYSTEM………………………………....p. 5
INFLUENTIAL EVENTS AND CONTROVERSIES………………………………………..
EXPERT OPINIONS…………………………………………………..
TRENDS……………………………………………………………………..
STAKEHOLDERS…………………………………………………..
EFFECT ON BUSINESS…………………………………………………..

FORESIGHT FORECASTING........................................................................p. 12
VARIABLES AND SOURCES OF DATA…………………………………………………
BASELINE FORECAST Dependent Variable: Childhood Obesity……………………………… Independent Variable: Food
Technology…………………………………….. Independent Variable: Government Regulations and Programs...………….. Independent Variable: Business Cooperation…………………………………….. Independent Variable: Food Production………………………………………….. Synthesis of Variables……………………………………………………………… SCENARIOS and BUSINESS IMPLICATIONS..............................p. 24

EXPECTED SCENARIO: “FAT” Implications Uncertainties “THE SLOW DOWN” Implications “TIGHTENING THE BELT” Implications “THE SLIM DOWN” Implications

CONCLUSION........................................................................................................p. 31

“What is the future of childhood obesity as it relates to trends and changes in food technology and the food production process”

INTRODUCTION

In order to find an answer to this question, this report first creates a framework for the question above by completing a current assessment of the childhood obesity, food technology, and food production processes as they are in today’s society.
This is done by determining the structure of the system, analyzing events which have influenced the topic, consulting experts in the sector for information, thinking about trends which will drive future changes, addressing the influence of stakeholders, discussing controversies, and finally explaining how business will be affected.
Second, this report takes a look at a few of the many variables which will work to shape this trend in the next 20 years; specifically, food technology, the food production process, government regulations, and business cooperation. After defining these variables, quantitative data describing historical trends for each variable is displayed, explained, analyzed, and used to make projections past the present and up until the year 2030.
The third section of this report describes potential future scenarios and the business implications of each. From there, the common denominators from each scenario are compiled to make a singular business strategy.
CURRENT
ASSESSMENT
Structure And Current State Of The System
The discussion of health and wellness has become more and more popular in today’s society. One of the reasons for this is the rising trend of obesity and more specifically, childhood obesity. The Centers for Disease Control and Prevention (CDC) states the number of obese children has more than tripled in the past 30 years with the percentage of children ages 6-11 in the U.S. rising from 7% in 1980 to almost 20% in 2008 (CDC). As the number of obese children in America rises, so does the likelihood of health and wellness problems. These complications include psychosocial difficulties, eating disorders, and the effects of inappropriate expectations of obese children whose growth is increased (Dietz, 523). There are many explanations as to why children become obese. While genetic predispositions play a small role, the most common explanation is a caloric imbalance which occurs when too few calories are expended for the amount of calories consumed (CDC). In other words, due to either a lack of nutritional food consumed or a lack of proper exercise, children are not burning enough calories relative to the calories they consume. Research has shown that there has been a clear trend in the U.S. toward increased dietary energy intake; in fact, the caloric intake of the U.S. population has increased about 200 kilocalories per day over the past 20 years. Much of this increase has been attributed to increased consumption in “empty” calories, specifically sugary beverages (Caballero, 2). This, along with an increasingly sedentary lifestyle, has led to the caloric imbalance described by the CDC. While the short-term effects which occur with the rising obesity rates in children are known, such as weight gain or the development of Type II Diabetes, the long-term effects are not. Unfortunately, the only way to discover the long-term effects is to record the effects as the obese children of today get older. If significant actions are not taken, the trend of childhood obesity will result in countless negative consequences for the upcoming generation.
Focusing specifically on the nutritional value of food commonly consumed by children, the United States has a lot of room to improve. Four major drivers of change in childhood obesity which pertain to the nutritional value of food are the study of food technology, the food production process, government regulations, and business cooperation. Since these four variables have a major influence on the system as a whole, they will be discussed more in depth in the following section.

Trends
As mentioned previously, there are four trends that act as the main drivers of change regarding childhood obesity. These trends can be grouped into the broad categories of food technology, food production, government regulation, and business cooperation. There are also a few trends that act as minor drivers of change in this area: rising healthcare costs, increased advertising to children, changes in family dynamics leading to more single parent households and more moms in the workforce, and more people eating out. Since the first four are the most influential, they will be dissected further throughout this entire paper whereas the minor ones will be briefly talked about in this section in order to give a fuller picture of the issue at hand.
FOOD TECHNOLOGY
One trend that could drive future change in this system is food technology. The leading expert in the food technology field is the Institute of Food Technologists (IFT) which is a non-profit scientific society of individual members with the mission to advance food science as well as try to ensure a safe and abundant food supply for the future which will contribute to healthier people everywhere (Floros, 572). IFT defines food technology as “the application of food science to the selection, preservation, processing, packaging, distribution, and use of safe food” (IFT). By studying food science, researchers have been able to work on finding methods to make advances in food technology and the way by which foods are processed. There are now ways in which sensitive nutrients can be preserved, important vitamins and minerals can be added, and toxins and anti-nutrients can be removed (Floros, 574). Essentially, with advances in technology and processing, food can be designed to optimize health. Experts believe that these processes (along with major lifestyle changes) could be used to make a big impact in the childhood obesity epidemic (Floros, 579). If biologically healthy foods can be created on large scale and served in places which are stereotypically unhealthy, such as fast food restaurants, food technology will have a huge impact.
FOOD PRODUCTION
A second driver of change is the food production process. Economic Research Service of the USDA describes food production as a complex network of farmers and the industries that link to them. Those links include makers of farm equipment and chemicals as well as firms that provide services to agribusinesses, such as providers of transportation and financial services. Food production also includes the food marketing industries that link farms to consumers, and which include food and fiber processors, wholesalers, retailers, and foodservice establishments (USDA).
Currently, food production in the United States emphasizes low budget, and long shelf life of foods. In order in produce these foods, producers pump foods with high fructose corn syrup, artificial sweeteners and colors, and excessive amounts of fats and sodium. According to he USDA, The United States is the world 's largest consumer of sweeteners, including high-fructose corn syrup. Also, farmers use pesticides and other chemicals to produce more fruits and vegetables for consumers. Using all of the chemicals and additives drastically decreases the nutritional value of these foods and causes the consumer to gain unwanted weight.
The top five food producers in the U.S. are Pepsico Inc., Tyson Foods, Nestle, Kraft Foods, and Anheuser-Busch. All of these companies earn over $25 billion in sales each year (Food Processing Top 100).
GOVERNMENT REGULATION
The government is a key driver of change because of its ability to regulate the food industry. Since obesity has become a growing concern, the government has done more to regulate business in the food industry. In a provision of the Affordable Care Act, President Obama laid out general requirements that all restaurants, retail food establishments, and vending machines that are part of a chain with twenty or more locations must disclose nutrition facts on standard menu items offered for sale. This entails that restaurants like McDonald’s that were once protected from the FDA’s nutrition labeling requirements by exemption are no longer exempt from these requirements under the law (Health Reform GPS). Another restriction the government can impose that is currently being researched is a food tax. This food tax would be placed on unhealthy foods and serve as a sin tax in order to dispel people from purchasing unhealthy choices. There have been several studies performed to see if this would be effective and the results seem to show that it will only have a significant effect at a certain price. For example, one study conducted in Great Britain stated that food taxes would only be effective if they were 20% or more of the purchase (US News). Although there has not been any legislation passed imposing food taxes on all the states, the possibilities of this occurring increase as the amount of obese individuals, especially children, increase.
BUSINESS COOPERATION
Fourth, for the purposes of this report, business cooperation can be defined as a business’ willingness to adopt new ideas or regulations. Businesses in the food industry have a huge influence on the future of childhood obesity because they essentially determine the consumption habits of the United States. Whatever is listed on the menu is what Americans have to choose from and lately there has been an increasing trend of shaping the menu. More and more food places are adding new options to their lists of dishes in order to appeal to the consumers who are asking for healthier choices. For example, Wendy’s allows customers to choose from multiple side dishes to go along with their meal such as chili, a baked potato, salad, or apple slices. In addition, Wendy’s is also changing the way they prepare their fries by making them naturally-cut and adding sea salt instead of regular table salt that is less healthy. This gives consumers the choice to eat a healthier meal that they did not have the luxury of choosing before. Although it is not a huge improvement, it is a start that can lead to better things. According to the foot-in-the-door phenomenon, a marketing concept for sales people, people are more likely to act on a bigger request if they had previously acted on a smaller one (Psych Central). This being applied to businesses, if restaurants like Wendy’s have started to appeal to customers’ wants by providing a simple menu change, this sets them up for being more likely to adopt bigger changes later on.
HEALTHCARE
The trend in rising healthcare costs has been a concern for many, especially during Barack Obama’s presidency. On March 23, 2010, Obama passed the Affordable Care Act in order to make healthcare available to everyone (Healthcare.gov). This controversial bill left some Americans angry about the potential increases in healthcare costs they would have to pay in order to cover those without insurance. Ironically, these same Americans are also paying added expenses in order to cover the portion of the population that is obese. The First Lady, Michelle Obama, states that $147 billion dollars a year of healthcare costs pertain to weight-related problems specifically (Hall, Hellmich, USA Today). This is a huge expense for a nation that is already deep in debt and it is one that can be eliminated with careful consideration and a focus on promoting health and wellness. A passage from the article, Preventing Childhood Obesity: Health in the Balance, a publication by the Institute of Medicine of the National Academies, provides a stark, yet realistic view of the matter; “The growing obesity epidemic in children, and in adults, affects not only the individual’s physical and mental health but carries substantial direct and indirect costs for the nation’s economy as discrimination, economic disenfranchisement, lost productivity, disability, morbidity, and premature death take their tolls” (Koplan, Liverman, Kraak). This quote not only highlights the consequences imposed on the economy, it also brings to light other consequences faced by those directly affected by this epidemic. Since so many consequences can arise from a preventable issue, and since the healthcare system is changing as we speak, a push to cut our nation’s debt down in any way possible will add to the push for healthier citizens.
ADVERTISING
Another trend greatly affecting childhood obesity is the increase in advertising to children. The largest study ever of T.V. ads for children found that children, ages 2 to 7, see an average of thirty hours of unhealthy food-related advertisements in a year while children ages 8 to 12 see an average of fifty hours a year (Whitaker). These numbers are staggering especially when considering how the type of advertising has changed over the years. In the 1990s, there were only about 52 food products targeted at kids. Just this year, however, that number has dramatically increased to around 500 products (Associated Press, MSNBC). This change in marketing techniques over the years is due to the change in appeal that children have to advertisers. This market segment is extremely appealing to advertisers because of how impressionable and loyal young children are to brands. Since they form brand preferences early on, the younger the child, the better the chance of forming a loyal bond with the customer. This has brought up ethical issues, however, considering that children under age 6 cannot distinguish between programming and advertising. Furthermore, children under age 8 are not aware of, nor understand, the persuasive intent of advertising (American Psychological Association). This means that marketers are potentially making unfair gains by targeting an unsuspecting and naive group of children. Of course, when the advertisements are promoting good habits such as exercise or healthy eating, they can be used as an educational tool to reach the younger population. But when over 40% of these commercials are promoting junk food and unhealthy eating practices, it is hard to say that advertising is not negatively affecting children (Whitaker). In fact, there has been a lot of speculation about how advertising affects children and whether there is a link between the increase in advertising and the increase in childhood obesity over the last few years.
FAMILY DYNAMICS / SOCIETAL CHANGES Family and household dynamics have been changing as the trend of marriage greatly decreases and the trend of divorce only slightly decreases. In the year 1990, there were 2,443,000 marriages in the United States, a rate of 9.8. But in 2009, this number dropped to 2,077,000 marriages or a rate of 6.8. The divorce rate in 1990 was 4.7 and in 2009 it slightly decreased to 3.4 (Census.gov). This means that there are more families headed by single parents who work a job, or perhaps multiple jobs, and have less time to perform activities such as cooking and cleaning at home (Consumer and Industrial Buying Behavior Lecture, Professor Bradford). This affects the number of families eating out. Another factor that plays a role in the number of families eating out is the societal change of women in the workforce. This increasing trend of women in the workforce instead of women being stay-at-home moms has risen from 43.3% in 1970 to 59.7% in 2010 (Bureau of Labor Statistics). If both parents are out working long hours, no one is home to cook dinner for the family. Ultimately, this time pressure results in the family resorting to convenient approaches such as fast food or eating out in general.

Influential Events And Controversies
A number of events and controversies have had a significant impact on the issue of increasing childhood obesity. These events and controversies include: technology advances which encourage sedentary lifestyles, several lawsuits, the annual Food Technology and Innovation Forum, the implementation of government regulations and taxes, government initiatives and campaigns, and the perceptions of food technology.
First, as the number of TVs owned per household increases, so does the trend of a less active, sedentary lifestyle. Playing outside with friends was once the only source of entertainment for children. Today, with technological advances in high-definition televisions, video-game consoles, and Blu-ray players, the less active and increasingly more popular option for childhood entertainment has become staying inside to watch television or play video games. The Third National Health and Nutrition Examination Survey, conducted between years 1988 and 1994, reported that over 26% of children age 8-16 years watched at least four hours of TV per day and 67% watched at least two hours (Chou, Rashad, Grossman, 21). During this same time period, the percentage of overweight children tripled (Chou, Rashad, Grossman, 23), which suggests that these two events are related. Another study found that the risk for childhood obesity increased by 12% for each hour a day spent watching television. Also, media time, defined as watching television/videos or playing video/computer games, was directly associated with BMI changes in both sexes. The reason that engaging in these activities is so dangerous is the combination of inactivity and the inclination to passively consume junk food (Ebbeling, 475).
A second event of interest is one of the most famous lawsuits with respect to childhood obesity, the Pelman versus McDonald’s case in 2003. It was brought to court in a failed attempt to hold McDonald’s liable for its customer’s obesity and obesity related illnesses, such as heart disease, diabetes, and high blood pressure (Falit, 725). In 2006, the case resurfaced in an attempt to claim that McDonald’s advertising was deceptive, its foods were unreasonably unhealthy and unsafe, and that McDonald’s failed to warn customers of the potential health risks of consuming their food (Falit, 726). The case was once again overturned; however, it influenced the public’s opinion of McDonald’s and influenced the company to re-strategize and offer new, healthier alternatives. As a result of this lawsuit, McDonald’s now features some sides that are healthier than fries, such as apple slices and other fruit.
Third, since food technology is a fairly new study, the Food Technology and Innovation Forum is a relatively new event held each year to spread awareness on this topic and try to find new strategies in the advancement of food technology. The 2012 summit was geared toward innovative product development, ingredient technologies, growth strategies, project execution, and brand management (Food Technology and Innovation Forum). Although very innovative, this conference is one of the only of its kind indicating that food technology has a lot of room for further development and adoption into society.
Next, as concerns about obesity increased, so has the amount of government regulations and legislature. One type of legislature which has become increasingly prevalent in recent years is a tax on unhealthy foods or drinks as a means to discourage purchase and consumption. In a study done by the British Medical Journal, a typical tax on sugary drinks imposed by some states in the US is between 1-8%. However, this study also determined that this tax must be at least 20% for it to have any positive impact on obesity (Mytton, 1). In other words, although the U.S. has put these taxes in place, they are not yet high enough to make an impact. The same is true for other forms of legislation in place to regulate the unhealthy lifestyles of children. A study done by BioMed Central discusses the few state regulations in place such as limiting the availability of foods with low nutritional value to children or requiring physical activity, to name a few (Benjamin, 1). Although these laws exist, they are not always monitored or strictly enforced (Benjamin, 9).
With respect to government campaigns and initiatives, one of the most recent was created by the first lady, Michelle Obama. Her “Let’s Move” campaign is geared toward spreading awareness of childhood obesity as well as educating parents and families about poor eating habits in order to help them find solutions that can be practiced at home (Hall, Hellmich, USA Today).
Finally, negative perceptions of food technology exist due to the way in which products are labeled and advertised (Slovic,12). Since little contact exists between consumers and manufacturers, consumers become uneasy when they see the use of chemicals and additives in food (Schmidt 2009). This is what has prohibited any major advancement in food technology up to present day.
Stakeholders
There are many relevant stakeholders in the future of childhood obesity. The major stakeholders include: the government, parents, children, food producers, food distributers, and those involved in the preparation and selling of food, specifically those in the grocery and restaurant business.
The government and parents are stakeholders who have the highest influence on this topic; however, their influences currently seem to clash. For instance, while the government attempts to implement plans to regulate unhealthy food, many parents would rather look for convenient options which satisfy their children’s wants rather than comply to government regulations. In this way, parents would be considered a constraint to change. Children, food producers, and distributers, and management in business which prepare and sell food are stakeholders who also can have a big influence on childhood obesity; however, they are not as interested in changing it as parents and the government. Children are a constraint to change in childhood obesity due to the influence they have over their parents buying decisions. The “nagging factor” describes a child’s ability to influence parent’s buying decisions by relentlessly begging for advertised food item; many times, unhealthy food items (Henry, 1). Producers and distributors could have an influence on future change in childhood obesity if they use food technology to change the way the produce and distribute food. They could also constrain change by using the same practices they have been using for years which, as noted, have contributed to the rise in childhood obesity. Restaurants, fast food restaurants in particular, can influence change by providing customers with healthier choices, adding calorie counts, or using healthier methods to prepare their food (i.e. baking as opposed to frying). Finally, lower level employees involved in the preparation and selling of food do not have much influence on childhood obesity nor do they have much interest in making changes.
Effect On Business
Key businesses, which could be affected by future change, include the gaming industry, food technology industry, and food production.
As previously mentioned, the gaming industry is flourishing because many children spend hours a day using their products. Companies such as Xbox, Nintendo, and Playstation have changed the way children communicate with each other. Many gaming consoles now offer wifi and Internet capabilities, which allows children to not only play video games, but have access to Netflix and other movie or TV shows, which increases their time in front of the television. High profit margins in this industry will leave the door open for new business ventures in the future.
In the food technology industry, businesses will be impacted because this trend will change how all food production, processing, and preservation occur. Food technology has the potential to create new markets in food research such as, food additives, nanotechnology, encapsulation, and non-thermal processing (IFT). Food additives have many very important technical functions in foods. Food additives contribute to the overall quality, safety, nutritive value, appeal, convenience, and economy of foods. Food and color additives have been the subjects of research and development, public policy, and regulatory activity as well as public interest for decades. Food additives allow food production industries to add necessary vitamins and minerals into foods we eat every day. Food additives have already been incorporated into foods and drinks such as milk, which has vitamin D added to it and flour is also enriched. Because food additives are so new, it is hard to tell the risks at this point in time. Researchers cannot see the long-term risks or benefits on humans if supplements were added to food.
Nanotechnology has great potential to positively impact the food industry through improvements of existing products and development of new ones. Although, this growing field holds tremendous potential, impending barriers and challenges must be addressed. Some controversies with food technology include concern from the use of antimicrobials in food production, manufacturing, and elsewhere may lead to the emergence of foodborne pathogens that are resistant to antimicrobials, thus compromising the ability to subsequently control them, whether in production agriculture, food processing, or human medicine.
A business sector which could shift in the public eye is the organic food market. Organic farmers and grocery stores, such as Whole Foods and Trader Joes, could start to become the new norm of shopping if consumers continue to shift into healthier lifestyles.

FORESIGHT FORECASTING

Of the many variables which will work to shape this trend in the next 20 years, this project focuses specifically on the effects of food technology, the food production process, government regulations, and business cooperation. First, these variables are defined, issues and obstacles regarding the variable are discussed, and relevant data sources are provided. Then, data describing the historical trends of each variable are displayed and explained. This data is then used to make projections past the present and up until the year 2030.
Variables And Sources Of Data
Childhood obesity can be described as the dependent variable in this project. Some of the relevant sources for data with regard to childhood obesity include the Center for Disease Control and Prevention, the National Institute of Health, Time Healthland, the American Heart Association, and Frost and Sullivan. These sources provide data which describes the past and current trends in obesity and childhood obesity which can be used to make predictions about the future. Data from these sources was used to create a graph displaying the trends in childhood obesity over the past 50 years.
However, the future of childhood obesity cannot be changed without forces working to change it. As mentioned, the four independent variables of interest include: food technology, the food production process, government regulations, and business cooperation.
The use of food technology through practices such as genetic engineering has been increasing in recent years. There is not much data on genetic engineering with regard to infusing nutrients into crops or food. Instead, data from the USDA regarding crops which were genetically engineered for insect resistance and herbicide tolerance is used instead for making inferences on trends in this type of technology and projections about the future.
Data on government regulations on permits for genetic engineering of crops was collected from the Virginia Polytechnic Institute and State University. It was difficult to find information related to trends in government regulations regarding living a healthy lifestyle. For the time being, several examples were provided.
Business cooperation is an important variable because if businesses, specifically restaurants in the food industry, are not willing to focus on health rather than profit, they may have a large and negative influence on childhood obesity in the coming years. Data regarding this trend was found in the American Journal of Public Health.
Finally, the data on food production revolves around trends regarding the prevalence of healthy foods (fruit and vegetables) or the amount of fat, protein, or sugars in food. This data was collected from the USDA.
Baseline Forecast
DEPENDENT VARIABLE: Childhood Obesity
Contrary to public opinion, the population of obese children has risen exponentially in the past 30 years. In 1980, the childhood obesity population was approximately 3.5 million and in just 30 years it has exploded to a staggering 12.5 million children. Figure 1, below, depicts this trend and how it will continue to rise exponentially through 2030, given that nothing changes.

Figure 1: Forecasted Child Obesity Population by 20301

INDEPENDENT VARIABLE: Food Technology
The first trend of interest with regard to food technology is the adoption of genetically engineered crops. This adoption has been on the rise in the past 15 years, as shown in Figure 2 below.

Figure 2: Adoption of genetically engineered crops in the U.S.2
The acronym “HT” refers to crops which have been engineered to be herbicide-tolerant crops and the “Bt” refers to insect-resistant crops. This graph indicates that percentages of each of these genetically engineered crops have grown. A second example of genetic crop adoption is shown in Figure 3:

Figure 3: Adoption of genetically engineered corn in the U.S.A. by trait 2000-123

Figure 3 illustrates the percentage of genetically engineered corn planted per acre. This graph indicates a general growth in genetically engineered corn, specifically insect-resistant crop and insect-resistant/herbicide tolerant crop. Figure 2 and Figure 3 are relevant to creating a baseline forecast for food technology because they show trends of specific food technologies over the past decade or so. These graphs indicate that the prevalence of this technology has been growing at a substantial rate. Although this data focuses on genetic engineering with respect to insect-repellent and herbicide tolerant technologies rather than genetic engineering to insert vitamins and nutrients into food, it is applicable because of the implication that this technology has been able to be adopted and implemented into farming at a rapid rate.
INDEPENDENT VARIABLE: Government Regulations and Programs
The next set of data, seems to indicate that there is a growing trend in government regulations and programs. The first example, below in Figure 4, shows the amount of permits released and approved by APHIS (Animal and Plant Health Inspection Service) for genetically engineered varieties over time.

Figure 4: Permits for release of GE varieties approved by APHIS4
Similarly, Figure 5 shows the total number of permits approved by APHIS, displayed by crop, while Figure 6 shows the total number of permits released by trait.

Figure 5: Total number of permits approved by APHIS, by crop5

Figure 6: Total number of permits approved by APHIS, by GE trait6
Figure 4 indicates that the number of permits increased drastically between 1987-1998, and then seemed to level off. Figure 5 shows that a majority of the crop genetic engineering permits approved by the government are for food crops. Finally, in Figure 6, none of the traits listed seem to refer to genetic engineering of crops for health reasons. This could be included in “Other”; however, “other” is still a very small section of the graph. This implies that there are not many government approved permits for genetic engineering of crops for health reasons. Although quantitative data is not provided at this point, it is important to note that increased government regulations and programs related to health and a healthy lifestyle for children will also be very important to creating changes in the future of childhood obesity. Current examples of such regulations and programs include Michelle Obama’s “Let’s Move” campaign (Hall, Hellmich, 2010) and laws enforcing calorie counts on menus in restaurants (Park, 2012).
INDEPENDENT VARIABLE: Business Cooperation
Despite suggestions or regulations of the government, there is a lot of data which suggests that many businesses in the food industry are not always willing to be compliant. Figure 7 shows results from a study performed where foods were sampled from popular take-out establishments (fast food restaurants and family style restaurants). The results indicate that many times, there is a drastic, even alarming, difference between actual portion sizes and recommended FDA and USDA portion sizes.
Figure 7: Percent Difference between Portion Sizes of Ready-to-Eat Foods and the Recommended FDA and USDA Portion Sizes7

Figure 8 demonstrates a similar concept by displaying the amount of large-size portions introduced in food establishments between 1970 and 1999. The introduction of large size portions grew from a meager 7 large-size portions introduced between 1970 and 1974 to about 65 new large-size portions introduced between 1995 and 1999. Examples of large-size portions include McDonalds’ “Super-Size” and Burger King’s “King-Size” options.

Figure 8: Number of Large-Size Portions Introduced8
INDEPENDENT VARIABLE: Food Production
One example of trends in food production can be seen by looking at changes in protein and fat in the U.S. food supply. Figure 9 shows that the percentage of fat included in the U.S. food supply has increased whereas the percentage of protein has decreased. By projecting the trend lines further, it appears that the percentage of fat in the U.S. food supply will reach levels over 90% and protein percentages will be in the low 60’s. This is not a promising trend with regard to the health of U.S. children.

Figure 9: Percentage of Protein and Fat Supply included in our Food Supply9

A second example of trends in food production is the trend related to amount of fruit and vegetables available per capita. According to Figure 10, there has been a decrease in the amount of fruit and vegetables available per capita. This could be due to the higher market demand for the production of commodity crops. In other words, farmers have a much greater incentive to produce commodity crops, such as sugar, than nutrient adding crops such as fruits and vegetables (Walinga).

Figure 10: Total Fruits and Vegetables Available per Capita in Pounds10
A third trend regarding food production can be seen by looking at the amount of added sugar and sweeteners per capita. Figure 11 shows that this number has actually declined over the past 10 years. This seems surprising due to the linear increase from 1982 to about 2000.

Figure 11: Total Amount of Added Sugar and Sweeteners Available per Capita11
Relationship between Independent and Dependent Variables
The relationship between each independent variable and childhood obesity has been described above. However, it should be noted that relationships between the independent variables exist as well. The most important relationship is between the development of food technology and businesses in the food industry. Dr. Adam Drewnowski, an expert on food enhancements from the University of Washington states, "Industry can play a significant role in developing and marketing foods that are nutrient dense, affordable and appealing. Making such foods more available in the world marketplace is something that the food industry definitely can do" (Experts 2012). In order for this to be possible, businesses must be willing to put in the resources and money to promote research in food technology. If businesses are not willing to give this support or adapt to the advancements in food technology, childhood obesity will continue to grow, which will be discussed later in the expected future scenario.
Correspondingly, government regulations have an influence on the three other independent variables. The government regulates permits and patents on food technology, regulates menus and advertising for food businesses, and imposes laws on food production. The government has the ability to ensure food technology practices are instilled within the food industry in a safe manor. The FDA can regulate the amount of preservatives, or fat content of food sold in restaurants. Dr. Barbara Rolls, an expert on feeding behavior at the Pennsylvania State University said, "Reducing energy density of food without compromising taste and flavor offers one promising tool toward weight management in kids," Dr. Rolls ' work has long focused on how to feel full on fewer calories, by adjusting food energy and food volume (Experts 2012). Ultimately, it comes down to the consumers’ willingness to buy these enhanced foods. Based on the interconnected relationships between the independent variables, an expected future scenario can be forecasted.
SCENARIOS AND BUSINESS IMPLICATIONS

Now that predictions for each variable have been made and the relationships between variables have been defined, a narrative describing the “expected future” will be provided. In this case, the expected future refers to how the future of childhood obesity will look like in 2030, with respect to the variables mentioned above. However, this future is not guaranteed. There is no way to be certain that any of these variables, or child obesity in general, will behave as predicted. Because of this, following the expected future is an explanation of potential uncertainties concerning these variables. From these uncertainties, three potential alternative scenarios are created and their implications on business described in detail.

EXPECTED FUTURE NARRATIVE: ‘FAT’
It is the year 2030. Currently 164 million U.S. citizens are obese. The cost of treating obesity-related diseases, including diabetes, heart disease and stroke, are $66 billion higher than last year alone. More specifically, spending on obesity-related medical problems has jumped from 13 to 16 percent each year up until now, with only about 4 percent of the increase due to an aging population. The rise in obesity has led to 7.8 million additional cases of diabetes, 6.8 million additional cases of coronary heart disease and stroke, as well as 539,000 additional cancer cases (Trippel). Today, Americans grow up living a sedentary lifestyle and have no reason to adjust their eating habits. These bad habits get passed from generation to generation which allows the problem to grow worse and worse. Food technology research exists, but has had little advancements. Due to negative perceptions of genetic enhancement in food or lack of funding for research, any possibility for upward trends in food technology could not compete with the exponential growth of childhood obesity. Another reason for the stagnant growth of food technology can be attributed to businesses and consumers not wanting to spend extra money to implement the technology or buy foods made with new techniques. This is ironic, considering the amount of money used to pay higher taxes and sky rocketing healthcare bills.
Due to the lack of food technology advance, food production techniques have remained the same. At this point, any attempt by the government to regulate the production of unhealthy foods or force the food industry to provide healthy options has failed. The government has not been able to successfully regulate the food production process or fund new food technology ventures as a means to preventing childhood obesity from growing. Americans are set in their ways and it is now nearly impossible to reverse the effects of obesity for most of the nation.
IMPLICATIONS FOR BUSINESS Since the “Fat” scenario describes the world if all trends progress as expected, businesses should not behave much differently than they are right now. As previously mentioned, research in food technology exists, but is struggling to advance due to the negative perceptions of consumers and a lack of funding. If the world moves in the direction of this scenario, it would be extremely unwise for businesses to invest in food technology.
Businesses in food production and distribution industry should take a look at their current business model and formulate a future plan which involves a gradual exaggeration of what they are currently doing to be profitable. For instance, food producers are currently being successful by creating foods high in calories, fat, and sugar and low in nutritional value for children. Since the trends point toward a dramatic increase in obese children, businesses should increase the production of these unhealthy foods and consider adding more sugar, fat, etc. In the case of food distributers such as grocery stores or restaurants, they should focus on providing unhealthier options on their menus and increasing the already large portion sizes.
A third industry which must make adaptations if the “Fat” scenario becomes reality is any producer of children’s toys or games. As children lead more sedentary lifestyles, there will be a smaller and smaller demand for toys which promote activity. Businesses should not invest in the creation of things such as bikes, jump ropes, jungle gyms, or even programs promoting activity. Rather, they should focus their efforts in places such as the gaming industry, specifically in video games which do not involve any kind of physical activity.
Fourth, the clothing industry for children may have to make adaptations for the growth of their consumers. If the growth of childhood obesity grows as expected, a much larger percentage of children will need clothing which fits a larger frame. Businesses may want to look into creating flattering clothing for this ever-increasing body type. Right now, few options exist. This would be a great place for businesses to gain a competitive advantage.
While many of these suggestions sound extreme or unrealistic, they provide profitable business strategies in the world described above. UNCERTAINTIES
The four major uncertainties that affect the rise or decline of childhood obesity are food technology, government regulations, the cooperation from businesses, and the manufacturing and food production process. If food technology and advancements in food production continue to improve then they could stop obesity from accelerating to the point detailed in the expected future. Food technology is a possible uncertainty because it is hard to determine if advancements in genetically enhanced foods will catch on in the future like the plant and pesticide repellants have recently. The ideas are out there already, but food technology could take years to develop and become a part of the cultural norm in America and the rest of the world.
The government is also a major contributor to stopping childhood obesity.
In order for food technology to advance the government needs to fund research and development centers. The government can also set regulations and taxes on unhealthy food options that cause obesity. The government is an uncertainty because they have already begun regulating food options and what goes into food, but obesity is still increasing even with these changes. The government needs to find a new approach to childhood obesity in order to be effective in the future.
Businesses need to cooperate and sell these new food options that could arise from food technology or else Americans will not get the benefits. It is uncertain if fast food restaurants, grocery store, etc. will adopt these new food products because it will change the current food system America has in place.
Above all American consumers must embrace and accept new government regulations, advancements in food technology, and changes to the food industry in order for these variables to aid in the prevention of childhood obesity. It is hard to determine which direction the variables will go, but laying out different scenarios help map possible
routes.

The following graph displays a visual representation of the chart above. The colors of the bubbles containing scenario names coincide with the colors of the trend lines.

Figure 12: Forecasted Child Obesity Population by 2030 with Alternate Scenarios12

‘The Slow Down’
In the first alternative scenario, the fast-paced childhood obesity epidemic slows down significantly, but does not disappear. Instead of growing exponentially, the number of children diagnosed as obese will grow at a slower rate. Advances in food technology will pick up slightly, allowing for slow positive growth in the industry as researchers continue examining ways to make food healthier. However, public opinion will still be an issue; scientists will constantly have to create ways to educate the public and to gain support for their techniques so that food technology can continue advancing. Genetically engineered food will not be completely embraced by the public due to ethical concerns. Nonetheless, newer, less controversial techniques will gain momentum and spark interest in the public as well as further research in the field.
There will not be much of a change in government regulations after a provision of the Healthcare bill was passed in October of 2012, making it mandatory that all restaurants post nutrition facts next to the meals on menus. More programs may emerge in elementary schools such as government induced lunch menus and restrictions on snacks and beverages in vending machines. A gym curriculum may also be imposed to ensure that kids are staying active while in school.
Business cooperation will slightly improve as restaurants, grocers, and other food industry companies try to stay competitive by responding to customer’s wants for healthier options. Fast food restaurants will make small changes such as offering wheat bread for sandwiches and burgers, reduced fat condiment packets, sea salt versus regular salt on their fries, and frozen yogurt in place of ice cream. Grocery stores will add an organic section so that customers who would rather shop for organic foods can have access to them without having to go to special stores.
Finally, production techniques will remain nearly the same as the traditional techniques used now. However, farmers may begin lending their crops toward food technology research in hopes that a successful technique will increase their farms’ worth.
IMPLICATIONS FOR BUSINESS
If the world moves in the direction of “The Slow Down” scenario, the main focus of scientists and researchers in food technology should focus on not only gaining awareness of the industry but also changing the public perception of the genetic enhancement of food. Advancements cannot be made until the public’s opinion changes so this should take priority over research initially.
Businesses in the food production industry will remain nearly the same; however, they should slowly begin accepting and implementing food production techniques. For instance, the first small changes could come in the form of producing organic food or reducing the amount of sugar and fat in products. Food distributors should integrate more of the organic or healthier products being produced. These products will still only be a small percentage of distributors inventory, but that percentage should increase as the demand for them increases. Restaurants should offer some meal options made with these organic and healthier products.
Producers of children’s toys and games will take a slightly different approach than in the expected scenario. Although less active gaming options will still be a major focus in this industry, there will be at least a slight increase in the demand for active games such as the Wii and toys such as bicycles.

‘Tightening the Belt’ In the second alternative scenario, the growing trend of childhood obesity will actually be constrained and a negative slope will start affecting the trend. This decline can be characterized as steady but slow. More and more children will make visits to the doctor and leave with either an improving health status or the satisfaction of “beating” childhood obesity. Parents will gain a piece of mind knowing that their children will have the chance to outlive them.
Awareness of new food technology techniques will reach a broader crowd through education seminars as well as government action to spread awareness. The government will step in to support and fund techniques that could potentially transform the way restaurants and grocery stores prepare food. Controversy will still plague many techniques, but the ones with the most research behind them will be justified and accepted by the public. As a result of this technology, meat will have less fat, vegetables more nutrients, fruits more vitamins, and meals less “bad” calories overall. Food companies, such as grocery stores, restaurants, and even most fast food restaurants have adopted these new practices in order to keep up with consumer demand stay relevant. The freshness of food will be emphasized, and companies will say goodbye to preservatives and mass production as a thing of the past. Artificial color and flavors will not be completely eliminated at this point, but their usage has clearly decreased. Constant updating and improvement will be expected as the food industry prepares for this new shift into healthier living. Since the focus on health will become more widespread, the cost of healthy foods will decreased dramatically, but will still slightly more expensive than the remaining unhealthy food options.
This is the preferred scenario. Even though “The Slim Down” scenario (to follow) involves a complete reversal of the childhood obesity trend, “Tightening the Belt” is the most realistic, positive scenario of the four. This scenario is the one which does the most to change the future of childhood obesity for the better with the most realistic chance of success in the 20 year time frame. Later, when considering an overall business strategy for businesses in this industry moving forward, the implications of all four scenarios will be considered, but the focus will be on creating a business strategy which will not only be profitable regardless of what scenario occurs but also help move the world in the direction of “Tightening the Belt”. ]
IMPLICATIONS FOR BUSINESS
If “The Tightening of the Belt” scenario becomes a reality, the main focus of scientists and researchers in food technology should be staying ahead of the competition within the industry. In order to do this, great efforts need to be made in order gain support of the government and public, obtain funding, and build a team of innovative scientists and researchers. From there, the main goal is to find ways to genetically enhance food without compromising taste.
Businesses in the food production industry should change in sync with food technology advancements. Once food technology techniques have been created and tested by scientists, companies should consider partnering with these researchers in order to gain rights to these practices and implement them into their production process. They should use advertising and marketing techniques to inform consumers of the use of genetic enhancement in their products in order to gain awareness and support. Another opportunity for food production companies lies in becoming more efficient in order to cut down the need for preservatives. For instance, they should focus on finding methods of growing, making, and transporting foods closer to major cities in order to reduce the time the overall process takes. Food producers can take advantage of vertical farms and roof top gardens within cities to make this a reality. Finally, companies should slowly begin reducing the amount of sugar in foods or amount of high calorie and high fat foods that they produce Restaurants should start purchasing more and more food which has been produced in a healthier way in order to provide the healthy and fresh options for consumers. This will produce a business opportunity for more health-focused restaurants and grocery stores since the demand for these stores is expected to increase in this scenario. Fast food restaurants should begin providing healthier options and start switching their less nutritious ingredients to new genetically enhanced or more healthily produced options. Another opportunity for the restaurant business would be gradually decreasing portion sizes. This will allow companies to cut costs because less food will be used per meal and less food will be wasted.
Toy and game producers in this scenario should take a similar approach as the previous scenario. They should focus their efforts on toys and games, which promote activity, as these will become more popular with healthier and more energized children.

‘The Slim Down’ In the third alternate scenario, childhood obesity will meet its match. The obesity trend will collapse in an extreme, exponential decline until obesity is nearly wiped out in the United States. Advancements in food technology will be a priority, giving rise to more jobs in this field of research. A push to discover new techniques that increase efficiency, cut down on waste, and benefit health will be highly encouraged by the government. The best techniques will be adopted in every place that deals with food, ensuring that Americans are eating the freshest and finest food available. Since the focus on health will be so widespread, costs for healthy foods will drop dramatically. Restaurants, specifically fast food restaurants, have either completely made over their business model or faded into obsolescence.
Government regulation will be at their strictest in order to impose certain standards, regulations, and requirements that need to be met with regards to production. Food will no longer be produced with preservatives, frozen for extended periods of time, infused with artificial coloring or flavor, or coated with harmful pesticides. Children will start begging their parents for more tasty fruits and vegetables. Parents with a strict time schedule can order fast food in full confidence that it will not put their children’s health at risk. Overall, America will be the healthiest country on the planet and the “lazy, fat, American” stereotype will cease to exist.
IMPLICATIONS FOR BUSINESS
If the world moves in the direction of “The Slim Down” scenario, great strides should be made by the researchers and scientists to find ways to genetically enhance foods without compromising taste. They should immediately start experimenting and developing techniques in order to be first movers in the soon-to-be-booming food technology industry. Once this technology becomes popular with the public, producers and distributers will be demanding methods and techniques to increase the healthiness of their products. The faster scientists can create healthy and tasty foods, the better chance they have of selling their techniques to food production companies.
Food producers should act now to find scientists and researchers who are making promising strides in this industry. Partnering with these scientists early will provide a competitive advantage over those who do not. These healthy and genetically enhanced products will be in high demand, so producers must do everything in their power to implement these practices as soon as possible. Another practice food producers should adopt is finding more efficient routes which will remove nearly all need for preservatives necessary in food. Once again, they could grow their own roof top garden to eliminate product transportation and provide the freshest ingredients available. Finally, producers should immediately start reducing the amount of sugar in foods or amount of high fat, high calorie foods that they produce.
Similarly, food distributers should partner with producers who are adopting these techniques. They should advertise themselves as companies who use products enhanced through food technology. Grocery stores should quickly begin increasing the amount of products which have been genetically enhanced or produced in healthier ways. They should make plans for making these products a majority of their inventory. Restaurants should make similar changes to accommodate consumer desires and make sure that these changes are well advertised. Fast food restaurants should begin making drastic changes to their business model and food produced if they do not want to become obsolete in this scenario. Another opportunity for the restaurant business would be decreasing portion sizes at a more rapid pace than the previous scenario. Once again, this will cut costs while promoting health.
Finally, makers of children’s toys and games should move their focus almost solely on products for active children. Due to improved diets, children will have a lot more energy and will want to engage in more physical activity. Video games should become more interactive and move solely toward consoles like the Wii or Xbox. Popular games on controller-based game consoles could be adapted to the active consoles. For instance, some of the popular fighting games could be changed so that the child is actually performing the motions of his character. Businesses should anticipate an increase in demand of toys like bikes or jump ropes and work on developing new “activity” promoting toys. This is a business opportunity for these companies to develop innovative products with today’s technology.

Overall Business Strategy The overall business strategy was compiled by considering the business implications of each possible scenario. The suggestions that follow provide businesses with innovative and profitable ideas to consider in order to maintain a competitive advantage moving forward regardless of what scenario actually occurs.
Although the expected future is possible, it is the worst case scenario for the future of the health of U.S. children and should be avoided at all costs. Since business has been defined as a driver of change, it is safe to assume that the actions of businesses in this industry could potentially work to change the expected future. Also, three of the four potential scenarios described entail a change in the future childhood obesity for the better. Because of this, the overall business strategy focuses on suggestions which allow businesses to be profitable and promote a healthier future for children while hopefully driving the United States toward the preferred future, “Tightening the Belt”.

FOOD TECHNOLOGY RESEARCH:

The top priority of food technology researchers should be employing campaigns or public forums to gain positive public awareness. Food technology companies could do this by assigning internal employees to the task or hiring a marketing team. Completing this task is crucial because the negative perception of the public is slowing down innovation in this field. If the public does not agree with this technology, then organizations or the government will not be willing to provide funding. Without funding, it is impossible for advancements to occur at a very fast pace, which in turn makes it unlikely that food technology will advance fast enough to be effective within the timeframe of interest (the next 20 years). While working tirelessly to gain positive awareness, the secondary focus of food technology researchers is to use existing funds to continue working on developing techniques which will genetically enhance the healthiness of foods without compromising taste. Any head start they can get on developing these techniques will provide a competitive advantage once the first goal is reached, once public and governmental acceptance is reached. Food technology companies who have developed (and potentially tested) techniques will have be most attractive to food producers looking to create a partnership.
Food Production: Although eventually attempting to partner with food technology companies, food producers should first focus on fixing internal problems which are contributing to childhood obesity. A place to start would be working on finding creative ways to reduce the time between when food is grown or made to when it is sold or consumed. This will reduce the need for as many artificial preservatives and allow food to be sold fresher. One suggestion is to

Food producers
While food technology techniques are being developed, work on other projects which promote health: i.e reducing sugar in foods, finding ways to create great tasting, but lower fat foods; reducing artificial colorings/flavorings
Work on finding creative ways to reduce the time between when food is grown/made to when it is sold/consumed to promote freshness/reduce the amount of preservatives. Perhaps finding more efficient shipping routes or implementing vertical farms (definition or description here perhaps). (any other ideas for preserving freshness/reducing preservatives)
Pay attention to what food technology researchers are doing; consider creating partnerships with any that seem promising

Food Distributers/Restaurants
Existing health food chains should consider opening more or bigger branches within the next 5 years (do we want to put years or just say that they should consider it in the future?) (trader joes, whole foods etc)
Opportunity for new health food stores
Existing grocery stores should slowly begin increasing inventory of organic and health food products
Pay attention to the advancements of food technology and any production companies that are making changes…consider partnering with food production companies who are making changes

CONCLUSION

Works Cited (to be fixed up..

Caballero, Benjamin. http://epirev.oxfordjournals.org.proxy.library.nd.edu/content/29/1/1.full.pdf+html

CDC. “Childhood Obesity Facts.” Centers for Disease Control and Prevention. 7 Jun 2012. Web. 27 Sept 2012. .

Children 's Hospital of Philadelphia. "Genes identified in common childhood obesity." ScienceDaily. 2012. Web. 26 Sept 2012 .

Chou, Shin-Yi, Inas Rashad, and Michael Grossman. “Fast-Food Restaurant Advertising on Television and its Influence on Childhood Obesity.” NBER Working Paper Series. Dec 2005. Web. 26 Sept 2012. .

Dietz, William H. "Health Consequences of Obesity in Youth: Childhood Predictors of Adult Disease." Health Consequences of Obesity in Youth: Childhood Predictors of Adult Disease., 26 Sept 2012. Web. 30 Sept 2012. .

Ebbelling… http://www.allhealth.org/briefingmaterials/lancetobesityrev-393.pdf (FINISH)

Falit, Benjamin. “Fast Food Fighters Fall Flak Plaintiffs Fail to Establish that McDonalds should be Liable for Obesity-related Illnesses”. The Journal of Law, Medicine & Ethics. 2003. 31: 725–729.
< http://onlinelibrary.wiley.com/doi/10.1111/j.1748-720X.2003.tb00140.x/pdf >

"Food Processing Top 100 Food and Beverage Companies." Food Processing Top 100 Food and Beverage Companies. N.p., n.d. Web. 27 Nov. 2012. .

Food Technology and Innovation Forum 2012. Web. 30 September 2012. .

Floros, John D. “Feeding the World Today and Tomorrow: The Importance of Food Science and Technology” Institute of Food Technologists: An IFT Scientific Review. Volume 9 Issue 5. (2010): 573-579.. 1 Oct 2012.

Franks, Paul W. “Childhood Obesity, Other Cardiovascular Risk Factors, and Premature Death” National Institute of Health. 2010. Web. 26 Sept 2012 .
Hall, Mimi, and Nanci Hellmich. "Michelle Obama Aims to End Child Obesity in a Generation - USATODAY.com." Michelle Obama Aims to End Child Obesity in a Generation - USATODAY.com. USA Today, 2 Feb 2010. Web. 30 Sept 2012. .

Henry… http://www.jhsph.edu/news/news-releases/2011/borzekowski_nag_factor.html

Mytton… http://www.bmj.com/content/344/bmj.e2931 finish

Park, Alice. "The New York City Soda Ban, and a Brief History of Bloomberg’s Nudges | Healthland | TIME.com." Time. Time, 31 May 2012. Web. 30 Sept 2012. .

“Report: TV ads contribute to childhood obesity.” NBCNEWS.com. 26 Dec 2005. Web. 26 Sept 2012. .

Schmidt DB. 2009. Environment and consumer perspectives surrounding processed foods. IFT Annual Meeting; 8 Jun 2009; Anaheim, Calif.
Shewfelt RL. 2009. Introducing food science. Boca Raton, Fla.: CRC Press. 385 p.
Sifferlin, Alexandra, and Maia Szalavitz. "‘Fat Tax’: Experts Argue Taxing Unhealthy Food and Beverages 20% Will Lead To Health Benefits | Healthland | TIME.com." Time. Time, 16 May 2012. Web. 30 Sept 2012. .

Slovic P. 1987. Perception of risk. Science 236:280–5. From forecast:
American Journal of Public Health. “The Contribution of Expanding Portion Sizes to the US Obesity Epidemic” February 2002. Web. 30 October 2012.

ChildStats.gov. 2012. Web. 30 October 2012.

Centers for Disease Prevention and Control. “NCHS Health E-Stat 2012.” 2012. Web. 30 October 2012.

FAOSTAT. 2012. Web. 30 October 2012.

Hall, Mimi, and Nanci Hellmich. "Michelle Obama Aims to End Child Obesity in a Generation - USATODAY.com." Michelle Obama Aims to End Child Obesity in a Generation - USATODAY.com. USA Today, 2 Feb 2010. Web. 30 Sept 2012. .

Park, Alice. "The New York City Soda Ban, and a Brief History of Bloomberg’s Nudges | Healthland | TIME.com." Time. Time, 31 May 2012. Web. 30 Sept 2012. .

Trippel, Ren. "Obesity in America Projected to Affect 164 Million by 2030." - Obesity -Public Health -. N.p., 1 Sept. 2011. Web. 01 Nov. 2012. < http://www.health.am/ab/more/obesity-in-america-projected/P2/>.
USDA, Economic Research Service. “Adoption of Genetically Engineered Crops in the US.” 2012. Web. 30 October 2012. < http://www.ers.usda.gov/data-products/adoption-of-genetically-engineered-crops-in-the-us/recent-trends-in-ge-adoption.aspx>

USDA. 2012. Web. 30 October 2012. ProQuest, University of Notre Dame Business Information Technology.

Virginia Polytechnic and State University. 2007. Web. 30 October 2012.

"Experts Supply Insight on New Ways to Tackle Childhood Obesity." Food and Beverage Close - Up (2012): n. pag. Pro Quest. Web. 1 Nov. 2012. .

Appendix A

Appendix B

Appendix C

Appendix D