The Commission to Prevent Childhood Obesity released a list of 14 recommendations to Governor John Lynch Tuesday. The recommendations include legislative and policy strategies to make healthy eating and physical activity choices more available to children in school, after-school programs and daycare settings.

A summary of the recommendations:

1. By October 2010, the New Hampshire Board of Education should create statewide rules regarding the sale and distribution of all food and beverages sold in schools that are not part of the United States Department of Agriculture's school meals program. The rules would include requirements that the food sold be single-serving sized and nutrient dense.

2. The state should require all chain restaurants to label menus so that nutritional information is available at point-of-purchase.

3. Ensure all schools in the state are adhering to an existing policy that requires them to adopt and implement daily physical activity and exercise plans for students.

4. Qualified school personnel should complete a comprehensive fitness assessment and provide a health report to children and parents each year.

5. The New Hampshire Department of Education should reinstate the Physical Education and Health Coordinator.

6. All licensed and licensed-exempt after-school programs should serve and/or promote healthy snacks and provide some form of physical activity every day.

7. Child care licensing requirements should be modified, no later than the next revision or three years (whichever comes first), to include specific language promoting physical activity and limiting sedentary time for children.

8. The New Hampshire Department of Health and Human Services should develop guidelines and an accountability procedure to ensure that all children in the direct care of the state receive a body mass index percentile-for-age assessment, at least one hour of daily physical activity and that meals served to them meet federal dietary guidelines.

9. Increase the number of schools in the New Hampshire Farm to School Program, which encourages schools to purchase food from local farms and helps children learn more about health eating.

10. Add a section to RSA 674:2 to address the importance of making communities places where people of all ages and physical abilities can easily and safely enjoy walking and bicycling as forms of transportation and recreation.

11. A law that requires all insurance carriers in New Hampshire (both Medicaid and private insurers) to provide a minimum of four registered dietitian visits, if clinically recommended, for all children with a BMI percentile-for-age equal or greater than 85 percent.

12. A continuing medical education unit for physicians, registered nurses, registered dieticians and other health care providers who work with children should be made available that specifically relates to childhood obesity.

13. All pediatric primary care providers should assess the BMI percentile-for-age for everyone between 2-20 years of age as part of their annual well child/well adolescent visit.

14. BMI percentile-for-age should be assessed every year in school by a qualified/trained individual and enforced through the school accreditation process.