Stopping Childhood Obesity before it Begins

Abstract

wish I had half their energy. If you're a parent or teacher of young children, you undoubtedly utter this phrase often. The energy of preschoolers seems so boundless it may not occur to parents, teachers, or even pediatricians that some children between ages two and five aren't getting enough or the right kind of exercise - and that it can lead to a lifelong struggle with obesity. Requiring physical activity as early as preschool may be the only way to keep children from developing the poor habits that contribute to obesity and are much harder to change as they get older. A barrage of public service announcements and campaigns such as First Lady Michelle Obama's Let's Move! program have made us aware that obesity is a major health concern, affecting one-third of adults and 17% of children and adolescents (Centers for Disease Control and Prevention, 2007; White House Task Force on Childhood Obesity, 2010). Perhaps more surprising is the rise in obesity rates for children under age five. The number of obese children between two and five has doubled over the past 30 years (Story, Kaphingst, & French, 2006) and almost tripled over the past 40 years (Skelton, 2009). Obese children are more likely to be obese adults and are at much greater risk for developing diabetes, hypertension, and high blood cholesterol. In addition to the negative health consequences, cognitive and affective consequences are also evident: Overweight children miss four times as much school as their normal-weight peers (Satcher, 2005), and obese children, especially girls, are more likely to maintain a poor body image (Strauss, 2000). Despite heightened awareness, we haven't gotten better at preventing obesity. When children start preschool, many already are not meeting recommended guidelines for physical activity (National Association for Sport and Physical Education [NASPE], 2010). Perhaps it's because parents and teachers don't take it seriously until children are older - when the consequences are more apparent. Or perhaps many of us focus on one factor, like diet and nutrition, and not on others, like exercise. Indeed, although most primary care physicians rate lack of exercise as an important barrier to obesity prevention and treatment, in first-year appointments with babies and their parents, 55% report they never discuss it (Spivack, Swietlik, Alessandrini, & Faith, 2010). Most parents and teachers believe young children are very active, and they may simply not know how much exercise children should be getting--or even recognize when they're overweight or obese (Baughcum, Chamberlin, Deeks, Powers, & Whitaker, 2000; Parry, Netuveli, Parry, & Saxena, 2008). Each day, preschoolers should accumulate two hours of exercise, including 60 minutes of structured physical activity and 60 minutes of unstructured physical activity (Pica, 2006). Further, Pica notes, 10-to 15-minute increments over the course of the day that yield 120 minutes is preferable; 30 minutes of continuous exercise could be developmentally inappropriate. Preschoolers shouldn't be sedentary for more than 60 minutes at a time (except when sleeping) and should develop competence in movement skills that are building blocks for more complex movement tasks, such as rolling, kicking, throwing, and catching (NASPE, 2010). Early intervention Preschool is a crucial time for obesity prevention, as children are developing eating and physical activity habits. A lack of physical activity at preschool may contribute more to overweight children than parental influences such as modeling and supporting physical activity or providing fitness equipment in the home (Trost, Sirard, Dowda, Pfeiffer, & Pate, 2003). Some 80% to 85% of children's time at preschool is sedentary (Cardon & De Bourdeaudhuij, 2008). The amount of physical activity this age group gets is highly contingent upon the preschool they attend (Trost, Ward, & Senso, 2010). …