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HPDP researcher working with two kids on healthy eating workshopA new national report offers policy recommendations to curb the high rates of obesity among America’s youngest children. The report, issued by the Institute of Medicine, includes guidelines such as 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.

Alice Ammerman, Dr.P.H., professor of nutrition at the University of North Carolina at Chapel Hill’s Gillings School of Global Public Health and director of the UNC Center for Health Promotion and Disease Prevention, served as an expert in nutrition and food marketing on the committee that issued the report. Other UNC nutrition faculty contributed their expertise.

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 noted that professionals can counsel and support parents in promoting healthy habits in the home, too.

About 10 percent of children under 2 years old and slightly more than 20 percent of children aged 2 through 5 are overweight or obese. Rates of excess weight and obesity among children aged 2 to 5 have doubled since the 1980s.

Dr. Alice Ammerman eating a pepper
Dr. Alice Ammerman

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

“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, Ph.D., distinguished professor of human development and director of the Center for Childhood Obesity Research at Pennsylvania State University.

The committee recommended a multi-pronged 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.
  • Sufficient Sleep. The amount of sleep infants and children get has decreased over the past two decades. 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, playing outside when possible. 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 aged 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.

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

Child care centers interested in implementing healthy changes can download the Let’s Move Child Care Checklist. The national program, led by first lady Michelle Obama, is based on the Nutrition and Physical Activity Self-Assessment for Child Care Program (NAPSACC), developed at the UNC Center for Health Promotion and Disease Prevention and led by nutrition professor Dianne Ward, Ed.D. Child care centers interested in implementing the program can receive training through UNC via Center TRT. Both NAPSACC and Center TRT were funded through the CDC Prevention Research Center Program.

The Institute of Medicine study was sponsored by the Robert Wood Johnson Foundation. The health arm of the the National Academy of Sciences, the institute provides independent, objective, evidence-based advice to policymakers, health professionals, the private sector and the public. For more information, visit the Institute of Medicine’s website.

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