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Kids' Healthy Weight

Start Early: Obesity Prevention in Early Care and Education Settings

The earliest years represent a crucial opportunity to promote healthy weight among children.

Childhood obesity has become an epidemic in the United States, where one in three children is either obese or overweight. Excess weight in childhood is of particular concern because overweight children are more likely to be overweight as adults, do not perform as well in school, and have more physical and mental health problems than children at healthy weights. Experts believe that children today will not live as long as their parents due to obesity. The increase in obesity is contributing to the rise in chronic conditions such as heart disease, type II diabetes, asthma, osteoarthritis and certain cancers. Excess weight is becoming more common at young ages. Over 20% of children ages 2-5 are overweight and about half of these children are obese. Over the next five years, the proportion of children that are overweight or obese roughly doubles.

Therefore, early learning and care is an especially important setting for obesity prevention.

Nearly three-quarters of all U.S. children ages 3 to 6 years are in some form of non-parental care. Of those children, 57 percent are enrolled in a center-based childcare program. Children consume a significant portion of their daily calories, and spend many of their waking hours in childcare.

Multiple strategies should be undertaken together for maximum impact.

There is No Magic Bullet

There is no magic bullet that will solve the obesity epidemic. Rather, experts recommend that community-based coalitions work together to identify priorities, set goals, share information, and measure success. Furthermore, changing environments where people work, eat, play and sleep can help prevent obesity. Child care settings present an important opportunity for individuals and organizations to come together to build healthy lifestyles. The strategies included in this document are based on research and experience in other communities that have been shown to help children achieve and maintain healthy weight over their lifetimes.

Early care settings present opportunities to affect children’s eating, physical activity and sleep habits. In addition, factors in this environment can influence patterns that will affect their weight, health and well-being for their entire lives. Based on expert recommendations the most important domains to consider include:

Caregivers should incorporate information about nutrition and physical activity into the curriculum. In addition, they should serve as role models by eating the same food served to children, sitting with them to eat, and eating age-appropriate portions. Caregivers should also participate in physical activity with children to serve as role models and to maintain their own health and well-being.

Engaging family members to support these healthy behaviors is essential to obesity prevention in early childhood. Parents of young children determine much of what children eat, and strongly influence their activity levels. At home, children should get messages about food choices and amounts, physical activity, screen time and sleep that are consistent with health-promoting messages in their early learning settings.

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Last Reviewed: Jun 23, 2013

Adjunct Associate Professor
School of Medicine
Case Western Reserve University