,,ii  #aafth ,,congress  #b;d ,session  
,s4 #diic  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,december #i1  
#bjbj,mr4 ,booker introduced the        
following bill2 which was read twice and
 referred to the ,committee on ,health1 
,education1 ,labor1 and ,pensions  ,a   
,,bill  ,to amend the ,public ,health   
,service ,act to promote healthy eating 
and physical activity among children4   
#a4 ,short title ,this ,act may be cited
 as the ,reducing ,obesity in ,youth    
,act of #bjbj4  #b4 ,findings and       
purposes  7a7 ,findings ,congress makes 
the following findings3 7#a7 ,the       
,,covid-#ai pandemic has had serious    
impacts on the health and well-being of 
children and families4  7#b7            
,unemployment and poverty1 likely       
exacerbated by business1 school1 and    
childcare closures1 have all contributed
 to elevated levels of food insecurity1 
with an estimated #ad1jjj1jjj children  
in the ,united ,states not getting      
enough to eat4  7#c7 ,millions of       

children receive free or reduced-price  
meals through early childhood education 
programs1 including school and early    
care and education programs such as     
childcare1 ,head ,start1                
pre-kindergarten1 and family childcare1 
making early childhood education an     
important setting for addressing food   
insecurity4  7#d7 ,more than #cj1jjj1jjj
 children receive free or reduced-price 
meals on a daily basis1 and access to   
both breakfast and lunch can provide    
some children with more than half of    
their daily caloric intake4  7#e7 ,due  
to financial instability during the     
,,covid-#ai pandemic1 there is an       
increased likelihood of unhealthy weight
 gain among children as families shift  
to less costly1 calorically-dense1      
shelf-stable foods1 rather than fresh   
foods4  7#f7 ,research has shown that   
early childhood is an important time for
 developing dietary and physical        
activity behaviors that support health  
and well-being and that may help prevent

 obesity4  7#g7 ,children who are       
exposed to healthy foods early are more 
likely develop eating habits that       
promote healthy growth that can continue
 throughout childhood1 and healthy      
eating can improve a child's learning   
ability1 potentially lead to higher     
academic performance1 improve mental1   
social1 and physical well-being1 and    
contribute to increased self-esteem4    
7#h7 ,research underscores the          
importance of physical activity in early
 childhood4 ,it is not only essential   
for healthy weight maintenance1 but also
 for practicing and learning fundamental
 gross motor skills and improving       
academic achievement4 ,furthermore1 when
 children have the opportunity for      
adequate physical activity1 they benefit
 physically1 psychologically and        
socially4  7#i7 ,nearly #bj percent 7#a 
in #e7 of #b-year-olds spend more than  
#b hours of a typical day watching      
television or videos1 and the ,journal  
of the ,american ,medical ,association  

,pediatrics found that each incremental 
hour of watching television at age #b is
 associated with corresponding declines 
in school engagement1 math achievement1 
and weekend physical activity1 and with 
increases in bullying by classmates1    
consumption of soft drinks and snacks1  
and body mass index at age #aj4  7#aj7  
,a study published in the ,new ,england 
,journal of ,medicine in #bjad found    
that a third of children with overweight
 in kindergarten had obesity by eighth  
grade4 ,almost every child with severe  
obesity remained that way1 suggesting   
that efforts must start much earlier and
 focus more on the children at greatest 
risk4  7#aa7 ,a study published in the  
,new ,england ,journal of ,medicine in  
#bjag estimates that over #ej percent of
 #b-year-olds today will be obese by #ce
 years of age4  7#ab7 ,a study examining
 the ,national ,health and ,nutrition   
,examination ,survey published in #bjah 
found an increase in prevalence of      
childhood obesity in #bjae and #bjaf4   

,childhood obesity for children between 
#b and #e years of age increased from #i
 percent to #ad percent1 the highest    
increase since #aiii4  7#ac7 ,in #bjaf1 
about #hb percent of ,united ,states    
preschool-aged children were in         
childcare1 and most of their day was    
spent in sedentary activities4  7#ad7   
,early care and education centers serve 
approximately #g1ejj1jjj children birth 
through age #e years but not yet in     
kindergarten1 making the early childhood
 care and education setting an important
 one for promoting healthful habits4    
7#ae7 ,more than #abb1jjj children in   
#ab ,states have benefitted from efforts
 to support healthier early care and    
education programs4 ,this includes the  
provision of training and coaching for  
childcare providers and technical       
assistance to ,state agencies to        
integrate nutrition and physical        
activity best practices into existing   
,state and local systems4  7b7 ,purposes
 ,the purposes of this ,act are to--    

7#a7 establish a program that will      
enhance the training and knowledge of   
early care and education providers and  
influence practices1 policies1 and      
environments in early care and education
 settings to support healthy eating and 
physical activity for children ages     
birth through #e1 including by          
addressing the growing threat of food   
insecurity2  7#b7 provide support to    
,states on ways to link early care and  
education programs to nutrition         
supports2  7#c7 monitor progress of     
healthy eating and physical activity    
promotion in early care and education   
settings2 and  7#d7 identify emerging1  
and expand existing1 approaches to      
engaging families and parents of        
children ages birth to #e in healthy    
eating and physical activity4  #c4      
,healthy kids program ,title ,,iii of   
the ,public ,health ,service ,act 7#db  
,u4,s4,c4 #bda et seq47 is amended by   
adding at the end the following3  ,w    
,healthy ,kids ,program  #cii,,oo4      

,definitions ,in this part3 7#a7        
,director ,the term ,director means the 
,director of the ,centers for ,disease  
,control and ,prevention4  7#b7 ,early  
care and education ,the term early care 
and education means programs and        
activities that serve children ages     
birth through #e years either through   
in-home or out-of-home settings1        
including childcare programs1 ,head     
,start programs1 family childcare1 and  
pre-kindergarten programs4  #cii,,oo-#a4
 ,grants  7a7 ,in general ,the          
,secretary1 acting through the ,director
 of the ,centers for ,disease ,control  
and ,prevention and in coordination with
 the ,assistant ,secretary for the      
,administration for ,children and       
,families1 shall award #e-year          
competitive grants to eligible entities 
to improve healthy eating and physical  
activity among children ages birth      
through #e years in early care and      
education settings4  7b7 ,eligibility   
,to be eligible to receive a grant under

 subsection 7a71 an entity shall-- 7#a7 
be-- 7,a7 a nonprofit organization with 
expertise in early childhood health and 
childhood obesity prevention2  7,b7 an  
institution of higher education or      
research center that employs faculty    
with relevant expertise and has         
expertise in training early care and    
education providers2 or  7,c7 a         
consortium of entities described in     
subparagraphs 7,a7 and 7,b7 that submit 
a single application to carry out       
activities under the grant jointly2 and 
7#b7 submit to the ,director an         
application at such time1 in such       
manner1 and containing such information 
as the ,director may require4  7c7 ,use 
of funds  7#a7 ,in ,general ,an entity  
shall use amounts received under a grant
 under this section to work directly    
with implementing partners1 which may   
include ,states1 territories1 ,indian   
,tribes1 municipalities1 and nonprofit  
organizations1 to-- 7,a7 create         
sustainable programs to train early care

 and education providers through direct 
coaching and peer-learning1 access to   
quality technical assistance1 and       
professional development opportunities  
that are focused on healthy eating1     
physical activity1 and addressing food  
insecurity2  7,b7 build ,state capacity 
through training1 technical assistance1 
and resources to integrate the promotion
 of healthy eating and physical activity
 into existing early care and education 
programs1 systems1 and initiatives1     
including helping to link early care and
 education programs with existing       
resources for nutrition supports2 and   
7,c7 test innovative or                 
evidence-informed approaches to engage  
families of children ages birth to #e   
years served in early care and education
 programs participating in this grant4  
7#b7 ,implementing partners ,in         
selecting ,states1 territories1 ,indian 
tribes1 municipalities1 or nonprofit    
organizations to be implementing        
partners under a grant under this       

section1 a grantee shall ensure that    
such partners-- 7,a7 serve populations  
that are racially1 ethnically1          
socioeconomically1 and geographically   
diverse2 and  7,b7 represent a mix of   
rural and urban settings4  7#c7         
,national independent evaluator ,from   
the amounts appropriated to carry out   
this section1 and prior to awarding any 
grants under paragraph 7#a71 the        
,director shall enter into a contract   
with an external entity to create a     
single1 uniform process to-- 7,a7 ensure
 that entities that receive grants under
 paragraph 7#a7 comply with the         
requirements of this section2 and  7,b7 
evaluate the outcomes of the grant      
activities carried out by each          
participating entity4  7d7 ,tracking    
,state progress ,the ,director may use  
amounts appropriated under subsection   
7f77#b7 to enter into contracts with1 or
 award grants to1 institutions of higher
 education1 nonprofit organizations1 or 
other entities with relevant monitoring 

and surveillance expertise1 for purposes
 of-- 7#a7 tracking ,state progress in  
obesity prevention policies and         
practices of early care and education   
programs in ,states where grantees are  
present2 and  7#b7 measuring changes in 
food security within exposed groups4    
7e7 ,report ,not later than #a year     
after the completion of the programs and
 activities funded under grants awarded 
under this section1 the ,secretary shall
 submit to ,congress1 and all           
appropriate agencies1 a report          
concerning an evaluation of the results 
of such programs1 activities1 and       
surveillance1 including best practices1 
and lessons derived from the experiences
 of grantees with respect to reducing   
and preventing food insecurity and      
obesity and overweight among children   
ages birth through #e years in the early
 care and education settings4  7f7      
,authorization of appropriations ,there 
is authorized to be appropriated to     
carry out this section-- 7#a7 #d1ejj1jjj

 for each of fiscal years #bjbb through 
#bjbf2 and  7#b7 #a1gjj1jjj for fiscal  
year #bjbb1 to be used to track ,state  
progress in obesity prevention policies 
and practices of early care and         
education programs in a sentinel set of 
,states as provided for in subsection   
7d74  4