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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:

  • Infant feeding: Human milk is best suited to meet the nutritional needs of infants. Experts recommend that children breastfeed without any additional food or liquid for their first six months. Children who are breastfed are more likely to maintain a healthy weight. Therefore, centers should encourage and enable mothers to provide breast milk for their infants.
  • Food service and feeding: Children’s food preferences develop early. Those who eat fruits and vegetables, low-fat or nonfat milk (over age 2) and dairy products, whole grains, and who avoid high calorie foods with little nutrition are more likely to remain at a healthy weight. Ensuring that child care workers eat with children and that they eat and serve age-appropriate portions will help children develop eating habits that help maintain a healthy weight. Drinking water should be available at all times.
  • Physical Activity and Screen Time: Children should have multiple opportunities to be active throughout the day, including both structured and unstructured activity. Also, infants should not have any time in front of screens and time for children over age two should be limited. When children are in front of screens, they are inactive and, often, exposed to marketing of unhealthy foods and beverages. Centers should also follow best practices to ensure that children get the amount of sleep that is appropriate for their age.

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.

For more information:

Go to the Kids’ Healthy Weight health topic.