Even as myths about obesity abound, researchers strive to determine the best means of preventing childhood obesity. One thing seems clear: The importance of starting early. If we can give the very youngest children a healthy start, it will be easier for them to maintain a healthy weight for years to come.
"We used to think that chubby babies would 'grow out' of their baby fat, but increasing scientific evidence suggests that we need to be concerned about extra weight in very young children, because a chubby baby often becomes an overweight adult," says Alice Ammerman, professor of nutrition at the University of North Carolina at Chapel Hill and director of the UNC Center for Health Promotion and Disease Prevention.
The Institute of Medicine, a prestigious research organization (charged with advising the U.S. government on medical matters), reviewed risk factors for obesity in children under 5. (Ammerman served on the committee that issued the report.) The Institute then developed recommendations for prevention of obesity in this age group. While these are intended for policymakers and care providers, they offer plenty of insight, and actionable suggestions, for concerned parents too.
Preventing Childhood Obesity with Physical Activity
Toddlers and preschoolers need opportunities for active play at home and at day care or preschool. Child care providers (and parents, for that matter) should reduce sedentary time by limiting the use of swings, bouncy seats, strollers, and so on. Practically, this could mean making sure your child has a child-proofed area where he can play freely, or letting him walk around the block on his own power instead of pushing him in a stroller (yes, this takes longer!).
Communities, too, must play a part in making sure small children have places to play outdoors, safely and actively. This might mean including playground equipment for little kids in public parks, for example, or safe sidewalks for families to use for doing errands and enjoying the outdoors together.
Preventing Childhood Obesity with Healthy Eating
One way to kids learn to eat healthfully is through breastfeeding. So adults who work with or care for babies should support breastfeeding for at least the first year of life. (A 2013 study did not find that longer, exclusive breastfeeding prevented obesity, but noted that nursing still offers many advantages to mothers and babies.)
Once young children begin to eat solid foods, we can provide them with healthy choices and appropriate portion sizes. The IOM recommends that the U.S. government's Dietary Guidelines for Americans (published every five years) be expanded to include recommendations for kids under two. These guidelines give citizens advice on ways to eat well, and they also form the basis for public policy related to nutrition (for example, requirements for kids' school lunches or foods served in after-school child care).
Both at school and at home, mealtimes are a learning experience for young children. They're a chance for adults to role-model healthy behaviors, like eating until we're full and then stopping. Letting little ones serve themselves (even if it's messy; using kid-sized utensils makes things easier) helps them understand their own hunger cues and learn about portion size.
Preventing Childhood Obesity with Better Sleep
Little kids need lots of sleep. The Institute of Medicine specifically recommends that adults help children get enough sleep for their age as a means to prevent obesity, and there is research to support this claim.
Both at home and in child care or preschool, we can encourage good sleep by creating restful sleeping environments and routines, and helping babies and toddlers learn to fall asleep and stay asleep on their own. Also, it's important to limit screen time. Too much TV not only disrupts sleep; it also takes time away from physical activities, and it exposes kids to marketing and advertising for unhealthy foods. Keep preschoolers (ages 2 to 5) to a max of two hours of screen time per day—30 minutes or fewer in child care settings.
Institute of Medicine: Early Childhood Obesity Prevention Policies. Washington, DC: The National Academies Press, 2011.
Martin RM, Patel R et al: Effects of Promoting Longer-term and Exclusive Breastfeeding on Adiposity and Insulin-like Growth Factor-I at Age 11.5 Years: A Randomized Trial. Journal of the American Medical Association, Vol 309 No 10, March 2013.