I 
118TH CONGRESS 
1ST SESSION H. R. 5788 
To amend the Public Health Service Act to promote healthy eating and 
physical activity among children. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 28, 2023 
Mr. COHEN (for himself, Ms. NORTON, Mr. DOGGETT, and Mrs. CHERFILUS- 
MCCORMICK) introduced the following bill; which was referred to the 
Committee on Energy and Commerce 
A BILL 
To amend the Public Health Service Act to promote healthy 
eating and physical activity among children. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Reducing Obesity in 
Youth Act of 2023’’. 
SEC. 2. FINDINGS AND PURPOSES. 
(a) FINDINGS.—Congress makes the following find-
ings: 
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(1) The COVID–19 pandemic has had serious 
impacts on the health and well-being of children and 
families. 
(2) Unemployment and poverty, as well as 
lengthy business, school, and child care closures, 
have all contributed to elevated levels of food insecu-
rity, with an estimated 14,000,000 children in the 
United States not getting enough to eat. 
(3) Millions of children receive free or reduced- 
price meals through early childhood education pro-
grams, including school and early care and education 
programs such as childcare, Head Start, pre-kinder-
garten, and family childcare, making early childhood 
education an important setting for addressing food 
insecurity. 
(4) More than 30,000,000 children receive free 
or reduced-price meals on a daily basis, and access 
to both breakfast and lunch can provide some chil-
dren with more than half of their daily caloric in-
take. 
(5) Due to financial instability during the 
COVID–19 pandemic, there is an increased likeli-
hood of unhealthy weight gain among children as 
families shift to less costly, calorically dense, shelf- 
stable foods, rather than fresh foods. 
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(6) Research has shown that early childhood is 
an important time for developing dietary and phys-
ical activity behaviors that support health and well- 
being and that may help prevent obesity. 
(7) Children who are exposed to healthy foods 
early are more likely develop eating habits that pro-
mote healthy growth that can continue throughout 
childhood, and healthy eating can improve a child’s 
learning ability, potentially lead to higher academic 
performance, improve mental, social, and physical 
well-being, and contribute to increased self-esteem. 
(8) Research underscores the importance of 
physical activity in early childhood. It is not only es-
sential for healthy weight maintenance, but also for 
practicing and learning fundamental gross motor 
skills and improving academic achievement. Further-
more, when children have the opportunity for ade-
quate physical activity, they benefit physically, psy-
chologically and socially. 
(9) Nearly 20 percent (1 in 5) of 2-year-olds 
spend more than 2 hours of a typical day watching 
television or videos, and the Journal of the American 
Medical Association Pediatrics found that each in-
cremental hour of watching television at age 2 is as-
sociated with corresponding declines in school en-
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gagement, math achievement, and weekend physical 
activity, and with increases in bullying by class-
mates, consumption of soft drinks and snacks, and 
body mass index at age 10. 
(10) A study published in the New England 
Journal of Medicine in 2014 found that a third of 
children overweight in kindergarten had obesity by 
the eighth grade. Almost every child with severe obe-
sity remained that way, suggesting that efforts must 
start much earlier and focus more on the children at 
greatest risk. 
(11) A study published in the New England 
Journal of Medicine in 2017 estimates that over 50 
percent of 2-year-olds today will be obese by 35 
years of age. 
(12) A study examining the National Health 
and Nutrition Examination Survey published in 
2018 found an increase in prevalence of childhood 
obesity in 2015 and 2016. Childhood obesity for 
children between 2 and 5 years of age increased 
from 9 percent to 14 percent, the highest increase 
since 1999. 
(13) In 2016, about 82 percent of United 
States preschool-aged children were in childcare, and 
most of their day was spent in sedentary activities. 
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(14) Early care and education centers serve ap-
proximately 7,500,000 children birth through age 5 
years but not yet in kindergarten, making the early 
childhood care and education setting an important 
one for promoting healthful habits. 
(15) More than 122,000 children in 12 States 
have benefitted from efforts to support healthier 
early care and education programs. This includes 
the provision of training and coaching for childcare 
providers and technical assistance to State agencies 
to integrate nutrition and physical activity best prac-
tices into existing State and local systems. 
(b) PURPOSES.—The purposes of this Act are to— 
(1) establish a program that will enhance the 
training and knowledge of early care and education 
providers and influence practices, policies, and envi-
ronments in early care and education settings to 
support healthy eating and physical activity for chil-
dren ages birth through 5, including by addressing 
the growing threat of food insecurity; 
(2) provide support to States on ways to link 
early care and education programs to nutrition sup-
ports; 
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(3) monitor progress of healthy eating and 
physical activity promotion in early care and edu-
cation settings; and 
(4) identify emerging, and expand existing, ap-
proaches to engaging families and parents of chil-
dren ages birth to 5 in healthy eating and physical 
activity. 
SEC. 3. HEALTHY KIDS PROGRAM. 
Title III of the Public Health Service Act (42 U.S.C. 
241 et seq.) is amended by adding at the end the fol-
lowing: 
‘‘PART W—HEALTHY KIDS PROGRAM 
‘‘SEC. 399OO. DEFINITIONS. 
‘‘In this part: 
‘‘(1) DIRECTOR.—The term ‘Director’ means 
the Director of the Centers for Disease Control and 
Prevention. 
‘‘(2) EARLY CARE AND EDUCATION.—The term 
‘early care and education’ means programs and ac-
tivities that serve children ages birth through 5 
years either through in-home or out-of-home set-
tings, including childcare programs, Head Start pro-
grams, family childcare, and pre-kindergarten pro-
grams. 
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‘‘SEC. 399OO–1. GRANTS. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Director of the Centers for Disease Control and Pre-
vention and in coordination with the Assistant Secretary 
for the Administration for Children and Families, shall 
award 5-year competitive grants to one or more eligible 
entities to improve healthy eating and physical activity 
and to address food insecurity among children ages birth 
through 5 years in early care and education settings. 
‘‘(b) ELIGIBILITY.—To be eligible to receive a grant 
under subsection (a), an entity shall— 
‘‘(1) be— 
‘‘(A) a nonprofit organization with exper-
tise in early childhood health and childhood obe-
sity prevention; 
‘‘(B) an institution of higher education or 
research center that employs faculty with rel-
evant expertise and has expertise in training 
early care and education providers; or 
‘‘(C) a consortium of entities described in 
subparagraphs (A) and (B) that submit a single 
application to carry out activities under the 
grant jointly; and 
‘‘(2) submit to the Director an application at 
such time, in such manner, and containing such in-
formation as the Director may require. 
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‘‘(c) USE OF FUNDS.— 
‘‘(1) 
IN
GENERAL.—An 
entity 
shall 
use 
amounts received under a grant under this section to 
work directly with implementing partners, which 
may include States, territories, Indian Tribes, mu-
nicipalities, and nonprofit organizations, to— 
‘‘(A) create sustainable programs to train 
early care and education providers through di-
rect coaching and peer-learning, access to qual-
ity technical assistance, and professional devel-
opment opportunities that are focused on 
healthy eating, physical activity, addressing 
food insecurity, and other topics that support 
children’s healthy development, as determined 
by the Director; 
‘‘(B) build State capacity through training, 
technical assistance, and resources to integrate 
the promotion of healthy eating and physical 
activity into existing early care and education 
programs, systems, and initiatives, including 
linking early care and education programs to 
new and existing resources for nutrition sup-
ports, with a focus on promoting equity; 
‘‘(C) test innovative or evidence-informed 
approaches to promoting healthy habits and 
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healthy child development in early care and 
education settings, which may include linking 
early care and education and health care pro-
viders, enhancing early care and education staff 
wellness, enhancing access to quality foods in 
the early care and education settings, and en-
gaging families of children ages birth to 5 years 
served in the early care and education programs 
supported by a grant under this section. 
‘‘(2) IMPLEMENTING PARTNERS.—In selecting 
States, territories, Indian tribes, municipalities, or 
nonprofit organizations to be implementing partners 
under a grant under this section, a grantee shall en-
sure that such partners— 
‘‘(A) serve populations that are racially, 
ethnically, socioeconomically, and geographically 
diverse; and 
‘‘(B) represent a mix of rural and urban 
settings. 
‘‘(3) NATIONAL INDEPENDENT EVALUATOR.— 
From the amounts appropriated to carry out this 
section, and prior to awarding any grants under 
paragraph (1), the Director shall enter into a con-
tract with an external entity to create a single, uni-
form process to— 
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