June 23, 2011
A new Institute of Medicine (IOM) report offers policy recommendations to curb the high rates of obesity among America’s youngest children. The guidelines include limiting television and other media use, encouraging infants and young children in preschool and child care to spend more time in physically active play, and requiring child care providers to promote healthy sleeping practices.

Dr. Alice Ammerman

Dr. Alice Ammerman

Alice Ammerman, DrPH, professor of nutrition at the UNC Gillings School of Global Public Health and director of the UNC Center for Health Promotion and Disease Prevention (HPDP), served as an expert in nutrition and food marketing on the committee that issued the report. Other nutrition faculty members also contributed.

 
The report outlines how children’s activities and behaviors can be better shaped by child care centers, preschools, pediatricians’ offices, federal nutrition programs, and other facilities and programs. Although the recommendations are directed toward policymakers and health care and child care providers, the report notes that professionals can counsel and support parents in promoting healthy habits in the home as well.About 10 percent of children from infancy to age 2 and slightly more than 20 percent of children ages 2 through 5 are overweight or obese. The rates of excess weight and obesity among children ages 2 to 5 have doubled since the 1980s.

“We used to think that chubby babies would ‘grow out’ of their baby fat,” Ammerman said. “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.”

“Child care providers, health professionals and policymakers can be helpful partners to parents in reducing obesity risk by creating healthy environments and implementing positive practices during the crucial early years of development,” said committee chair Leann Birch, PhD, Pennsylvania State University’s Distinguished Professor of Human Development and director of the university’s Center for Childhood Obesity Research.

The committee recommended a multipronged approach to combating early childhood obesity that includes identifying when young children show signs of excess weight, promoting healthy eating, increasing physical activity and ensuring adequate sleep.

“With obesity, perhaps more than any other health problem, the factors responsible are enormously diverse, complex and inter-connected,” said Ammerman. “This also means that there is no single, ‘magic bullet’ solution to the problem.”

The committee recommended a multipronged approach to combating early childhood obesity, including:

  • Identifying at-risk children. Health professionals should measure infants’ weight and length and young children’s body mass index at every well-child visit. They should identify children at risk for obesity and discuss with the risks linked to the children’s excess weight.
  • Sufficient sleep. During the past two decades, there has been an overall decrease in the amount of sleep infants and children get. Regulatory agencies should require child care providers to promote healthy sleep durations in their facilities. Pediatricians, early childhood educators, and other professionals should be trained to counsel parents about age-appropriate sleep times and good sleep habits.
  • Physically active play and sedentary activities. Children should be engaged in physically active play for a cumulative average of at least 15 minutes per hour spent in care, going outside to play when possible. Avoid using restriction of play as a disciplinary measure. Infants should be allowed to move freely with appropriate supervision. Child care providers should limit television viewing and use of computers, mobile devices, and other digital technologies to less than two hours per day for children ages 2 to 5.
  • Healthy Eating. Health care providers and organizations should step up efforts to encourage breastfeeding. All child care facilities and preschools should be required to follow meal patterns established by the federal Child and Adult Care Food Program, which promotes fruits, vegetables, whole grains, age-appropriate use of sugar, salt, fat and necessary nutrients, and provides guidance on appropriate portion sizes. Government officials should take steps to boost participation in nutrition assistance programs, as more than one-third of those eligible for the Supplemental Nutrition Assistance Program and 40 percent of those eligible for WIC – a nutrition program aimed at women, infants, and children – do not take advantage of the programs.

Child care centers interested in implementing healthy changes can download the Let’s Move Child Care Checklist.

 
The national Let’s Move program, led by first lady Michelle Obama, is based on the Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) study conducted at HPDP and led by nutrition professor Dianne Ward, EdD. The checklist helps child care centers rate physical activity, screen time, food served, beverages served and infant feeding.Child care centers interested in implementing the NAP SACC program can receive training through the Center for Excellence in Training and Research Translation, also a project based at HPDP. Online training is available.

The IOM study was sponsored by the Robert Wood Johnson Foundation. Established in 1970 under the charter of the National Academy of Sciences, the Institute of Medicine provides independent, objective, evidence-based advice to policymakers, health professionals, the private sector and the public. For more information, visit http://national-academies.org or http://iom.edu.

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UNC Gillings School of Global Public Health contact: Ramona DuBose, director of communications, (919) 966-7467 or ramona_dubose@unc.edu.

 

 

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