By Jennifer Eder
About one in four U.S. children ages 2 to 5 are overweight or obese.
Those rates, which are even higher for low-income, African-American and Hispanic children, are causing more children to be at risk for Type II diabetes, hypertension and joint disorders – health conditions once found mainly in adults.
“Childhood obesity is the number one problem in U.S. children,” said Nazrat Mirza, an associate professor of pediatrics at GW’s School of Medicine and Health Sciences and director of clinical and community obesity initiatives at the Children’s National Medical Center’s Obesity Institute.
Dr. Mirza and other health care professionals discussed successful intervention programs, ongoing challenges and prevention strategies for combating childhood obesity last week at the Children’s Pediatric Obesity Symposium.
Up until recently, most pediatric obesity prevention programs targeted school-age children, but studies have shown that many children are already overweight or obese when they enter preschool. According to statics from the National Health and Nutrition Examination Survey, almost 31 percent of low-income preschoolers are overweight or obese in the U.S.
“The time to focus on prevention is during infancy and toddler-hood so they can create healthy habits early,” said Maureen Black, a professor of pediatrics at the University of Maryland School of Medicine. “Physical activity and eating habits start in childhood and track into adulthood.”
While portion sizes, physical activity and the amount of time spent in front of televisions and computers contribute to pediatric obesity, other risk factors include whether a child was breast fed, when formula and solid food were introduced, the child’s race and ethnicity and whether the child comes from a low-income family.
Dr. Black suggested that parents make family dinners a priority, participate in physical activity with their children and limit the amount of sweetened beverages, processed food and sugary sweets in the home.
Traditionally, intervention programs have focused only on the child who’s overweight or obese. But Dr. Mirza said that prevention programs can’t just be about the child struggling with his or her weight. It has to involve the whole family, the school and the community.
“When you want to improve a problem like obesity, you have to take a multilevel approach,” said Dr. Mirza. “Community engagement is so important. Children need to see parents and teachers making healthy choices.”
In addition to providing a weight-loss management and a weight-loss surgery program, Children’s Obesity Institute offers prevention and wellness programs, such as Fit Family Jr. and Start Early, Start Right.
Fit Family Jr. is a nutrition, fitness and wellness program targeted to preschool children, their parents and preschool teachers in the Kenilworth-Parkside neighborhood in Southeast D.C. The program aims to prevent obesity in African-American preschoolers by promoting a healthy diet and active lifestyle. Activities include age-appropriate curricula and physical activity, cooking classes for parents and professional development for preschool teachers.
Start Early, Start Right is a free, nutrition-education program for Latino families with children ages 6 and younger living in Adams Morgan and Columbia Heights. The program focuses on healthy eating and an active lifestyle for young children. Parents learn appropriate portion sizes, healthy cooking skills and how to read nutrition labels.
Thomas Robinson, the Irving Schulman Endowed Professor in Child Health at the Stanford University School of Medicine and the director of the Center for Healthy Weight at the Lucile Packard Children’s Hospital at Stanford, said that most children are not motivated by the same factors that motivate health care professionals, such as preventing diabetes, stroke and heart disease. Instead, children are motivated by factors like competition, social interaction, fun, parental and peer approval, and therefore, clinicians and public health professionals need to create interventions and prevention programs with those factors in mind.
“We don’t necessarily have to talk about health to change health behavior or health outcomes,” said Dr. Robinson, who suggests schools hold competitions to see which children can go the longest without turning on their televisions at home.
Step Up to Health, another prevention program within Children’s Obesity Institute, uses an after-school stepping class to motivate African-American girls at the Washington Middle School for Girls in Anacostia to engage in more physical activity. During the program, girls attend a one-hour dance class taught by coaches at Howard University, work on their homework for 30 minutes and receive nutritional education for another 30 minutes. At the end of the Children’s Obesity symposium, the Washington Middle School girls performed a traditional step routine.
First Lady Michelle Obama’s “Let’s Move!” campaign is encouraging schools to adopt more programs like Step Up to Health in order for children to meet their daily recommendation of 60 minutes of moderate to vigorous activity. The “Let’s Move!” campaign aims by 2030 to bring the childhood obesity rate down to 5 percent – the level before the obesity rate began to creep up in the late 1970s.
The campaign focuses on ensuring access to healthy and affordable food, increasing physical activity in schools and communities, providing healthier food in schools and empowering parents to make healthy choices for their families.
“Let’s Move has created a social movement in obesity prevention,” said Dr. Robinson.