Skip Navigation LinksSkip Navigation Links
Centers for Disease Control and Prevention
Safer Healthier People
Blue White
Blue White
bottom curve
CDC Home Search Health Topics A-Z spacer spacer
Blue curve MMWR spacer

Persons using assistive technology might not be able to fully access information in this file. For assistance, please send e-mail to: Type 508 Accommodation and the title of the report in the subject line of e-mail.


Terms Used in This Report

Bike lanes: As defined by the American Association of State Highway and Transportation Officials (AASHTO), portions of a roadway that have been designated by striping, signing, and pavement markings for the preferential or exclusive use of bicyclists.

Bike routes: Cycling routes on roads shared with motorized vehicles or on specially marked sidewalks.

Coalition: A group of persons representing diverse public- or private-sector organizations or constituencies working together to achieve a shared goal through coordinated use of resources, leadership, and action.

Competitive foods and beverages: All foods and beverages served or sold in schools that are not part of federal school meal programs, including "à la carte" items sold in cafeterias and items sold in vending machines. As defined by the Institute of Medicine (IOM), competitive foods and beverages typically are lower in nutritional quality than those offered by school meal programs (1).

Complete streets: As defined by the National Complete Streets Coalition (, streets that are designed and operated to enable safe access along and across the street for all users, including pedestrians, bicyclists, motorists, and transit riders of all ages and abilities.

Construct validity: The accuracy of a measurement tool that is established by demonstrating its ability to identify or measure the variables or constructs that it intends to identify or measure.

Eating occasion: A single meal or snack.

Energy density. The number of calories per gram in weight.

Environmental Change: An alteration or change to physical, social, or economic environments designed to influence people's practices and behaviors.

Farm stand: Multiple and single vendors that are not part of a licensed farmers' market.

Farmer-day: Any part of a calendar day spent by a farmer (vendor) at a farmers' market (excluding craft vendors and prepared food vendors). The total number of annual farmer-days for a given farmers' market is based on the number of days that the farmers' market is open in a year multiplied by the number of farm vendors at the market on a given day.

Full-service grocery store: A medium to large food retail store that sells a variety of food products, including some perishable items and general merchandise.

Healthier foods and beverages: As defined by IOM, foods and beverages with low energy density and low content of calories, sugar, fat, and sodium (1).

Largest school district within a local jurisdiction: The school district that serves the largest number of students within a local jurisdiction.

Less healthy foods and beverages: As defined by IOM, foods and beverages with a high content of calories, sugar, fat, and sodium, and low content of nutrients, including protein, vitamins A and C, niacin, riboflavin, thiamin, calcium, and iron (1).

Local government facilities: Facilities owned, leased, or operated by a local government (including facilities that might be owned or leased by a local government but operated by contracted employees). For the purposes of this project, and according to the definition established by ICMA, local government facilities might include facilities in the following categories:

  • 24-hour "dormitory-type" facilities: facilities that generally are in operation 24 hours per day, 7 days per week, such as firehouses (and their equipment bays), women's shelters, men's shelters, and group housing facilities for children, seniors, and physically or mentally challenged persons, not including regular public housing;
  • administrative/office facilities: general office buildings, court buildings, data processing facilities, sheriff's offices (including detention facilities), 911 centers, social service intake centers, day care/preschool facilities, historical buildings, and other related facilities;
  • detention facilities: jails, adult detention centers, juvenile detention centers, and related facilities;
  • health care facilities: hospitals, clinics, morgues, and related facilities;
  • recreation/community center facilities: senior centers, community centers, gymnasiums, public parks and fields, and other similar recreation centers, including concession stands located at these facilities; and
  • other facilities: water treatment plants, airports, schools, and all other facilities that do not explicitly fall into the categories listed above.

Low energy dense foods and beverages: Foods and beverages with a low calorie-per-gram ratio. Foods with a high water and fiber content are low in energy density, such as fruits, vegetables, and broth-based soups and stews.

Maternity care practices (related to breastfeeding): Practices that take place during the intrapartum hospital stay, including prenatal care, care during labor and birthing, and postpartum care. Maternity care practices supporting breastfeeding might include developing a written policy on breastfeeding, providing all staff with breastfeeding education and training, encouraging early breastfeeding initiation, supporting cue-based feeding, restricting supplements and pacifiers for breastfed infants, and providing for post-discharge follow-up.

Measure: For the purposes of this project a measure is defined as a single data element that can be collected through an objective assessment of the physical or policy environment and used to quantify an obesity prevention strategy.

Mixed-use development: Zoning that combines residential land use with one or more of the following types of land use: commercial, industrial, or other public use.

Network distance: Shortest distance between two locations by way of the public street network.

Nonmotorized transportation: Any form of transportation that does not involve the use of a motorized vehicle such as walking and biking.

Nutrition standards: Criteria that determine which foods and beverages may be offered in a particular setting (e.g., schools or local government facilities). Nutrition standards may be defined locally or adopted from national standards.

Partnership: A business-like arrangement that might involve two or more partner organizations.

Policy: Laws, regulations, rules, protocols, and procedures, designed to guide or influence behavior. Policies can be either legislative or organizational in nature.

Portion size: Amount of a single food item served in a single eating occasion (e.g., a meal or a snack). Portion size is the amount (e.g. weight, calorie content, or volume) of food offered to a person in a restaurant, the amount in the packaging of prepared foods, or the amount a person chooses to put on his or her plate. One portion of food might contain several USDA food servings.

Pricing strategies: Intentional adjustment to the unit cost of an item (e.g., offering a discount on a food item, selling a food item at a lower profit margin, or banning a surcharge on a food item).

Public recreation facility: Facility listed in the local jurisdiction's facility inventory that has at least one amenity that promotes physical activity (e.g., walking/hiking trail, bicycle trail, or open play field/play area).

Public recreation facility entrance: The point of entry to a facility that permits recreation. For the purposes of this project, geographic information system (GIS) coordinates of the entrance to a recreational facility or the street address of the facility.

Public service venue: Facilities and settings open to the public that are managed under the authority of government entities (e.g., schools, child care centers, community recreational facilities, city and county buildings, prisons, and juvenile detention centers).

Public transit stops: Points of entrance to a local jurisdiction's transportation and public street network, such as bus stops, light rail stops, and subway stations.

School siting: The locating of schools and school facilities.

Screen (viewing) time: Time spent watching television, playing video games, and engaging in noneducational computer activities.

Shared-use paths: As defined by AASHTO, bikeways used by cyclists, pedestrians, skaters, wheelchair users, joggers, and other nonmotorized users that are physically separated from motorized vehicular traffic by an open space or barrier and within either the highway right-of-way or an independent right-of-way.

Sidewalk network: An interconnected system of paved walkways designated for pedestrian use, usually located beside a street or roadway.

Street network: A system of interconnecting streets and intersections for a given area.

Sugar-sweetened beverages: Beverages that contain added caloric sweeteners, primarily sucrose derived from cane, beets, and corn (high-fructose corn syrup), including nondiet carbonated soft drinks, flavored milks, fruit drinks, teas, and sports drinks.

Supermarket: A large, corporate-owned food store with annual sales of at least 2 million dollars.

Underserved census tracts: Within metropolitan areas, a census tract that is characterized by one of the following criteria: 1) a median income at or below 120 percent of the median income of the metropolitan area and a minority population of 30 percent or greater; or 2) a median income at or below 90 percent of median income of the metropolitan area. In rural, non-metropolitan areas, the following criteria should be used instead: 1) a median income at or below 120 percent of the greater of the State non-metropolitan median income or the nationwide non-metropolitan median income and a minority population of 30 percent or greater; or 2) a median income at or below 95 percent of the greater of the State non-metropolitan median income or nationwide non-metropolitan median income (US Department of Housing and Urban Development, 24 CFR Part 81, 1995).

Violent crime: A legal offense that involves force or threat of force; according to the Federal Bureau of Investigation's Uniform Crime Reporting Program, violent crime includes four offenses: murder, forcible rape, robbery, and aggravated assault (2).


  1. Institute of Medicine. Preventing childhood obesity: health in the balance. Washington, DC: The National Academies Press; 2005.
  2. US Department of Justice, Federal Bureau of Investigation. Crime in the United States, 2007. Washington, DC: US Department of Justice, Federal Bureau of Investigation; 2007. Available at

Use of trade names and commercial sources is for identification only and does not imply endorsement by the U.S. Department of Health and Human Services.

References to non-CDC sites on the Internet are provided as a service to MMWR readers and do not constitute or imply endorsement of these organizations or their programs by CDC or the U.S. Department of Health and Human Services. CDC is not responsible for the content of pages found at these sites. URL addresses listed in MMWR were current as of the date of publication.

All MMWR HTML versions of articles are electronic conversions from typeset documents. This conversion might result in character translation or format errors in the HTML version. Users are referred to the electronic PDF version ( and/or the original MMWR paper copy for printable versions of official text, figures, and tables. An original paper copy of this issue can be obtained from the Superintendent of Documents, U.S. Government Printing Office (GPO), Washington, DC 20402-9371; telephone: (202) 512-1800. Contact GPO for current prices.

**Questions or messages regarding errors in formatting should be addressed to

Date last reviewed: 7/14/2009


Safer, Healthier People

Morbidity and Mortality Weekly Report
Centers for Disease Control and Prevention
1600 Clifton Rd, MailStop E-90, Atlanta, GA 30333, U.S.A


Department of Health
and Human Services