At a young age physical activity and eating habits for a lifetime can develop. As preschool child care usage rises and the commonness of childhood obesity is at an all-time high, the opportunity to positively influence eating and physical activity habits within this setting presents itself. In the September 2011 issue of the Journal of American Dietetic Association a study describes and examines research addressing opportunities and plans for the prevention of obesity among preschool children in child-care surroundings. The current status of state regulations, practices and policies, and interventions for promoting healthy eating and physical activity are evaluated in the review.
Lead author Nicole Larson, PhD, MPH, RD, Research Associate in the Division of Epidemiology and Community Health at the University of Minnesota said:
“Early prevention is considered to be the most promising strategy for reducing obesity and the many serious health conditions that may result as a consequence of excessive weight gain in childhood.
Eating and activity behaviors formed during the preschool years have the potential to prevent obesity in the short term, and if carried into adulthood, to set the stage for a lifetime of better health. The majority of U.S. parents depend on child-care providers to support the development of healthful behaviors by providing their young children with nutritious foods and regular physical activity. Significant improvements in the eating and activity behaviors of preschool children will likely depend on the combined strength of interventions and supportive policy changes.”
A comprehensive review of the research literature was conducted by researchers from the School of Public Health, University of Minnesota, the Gillings School of Public Health, University of North Carolina at Chapel Hill, and the Duke University Medical Center. They identified and evaluated 42 relevant investigations that can act as baselines against which future progress may be measured. These included 4 reviews of state regulations, 18 investigations of child-care practices and policies that may influence eating of physical activity behaviors, 2 investigations on parental perceptions and practices relevant to obesity prevention, and 18 evaluated interventions. Interventions implemented in international settings were also included, although the research concentrated on the U.S. The review of the existing evidence was funded by Healthy Eating Research, a national program of the Robert Wood Johnson Foundation.
In the U.S. child-care facilities are mainly regulated by individual states. The set of regulations for licensed child-care facilities and minimum enforcement standards to assess compliance are established by each state. Yet, there is a gap between existing state regulations for child-care settings and the standards advised by public health professionals, recent reviews indicated. Strong regulations connected to healthy eating and physical activity were lacking in most states. There was strong variation among states in promoting 8 key nutrition and physical activity measures in child-care settings. For example, while Tennessee covered 6 of the 8 factors, the District of Columbia, Idaho, Nebraska and Washington had none.
Larson explained:
“These reviews identified a number of opportunities for enhancing state regulations by comparing existing regulations with relevant national standards and recommendations from professional groups, including the American Dietetic Association, the American Academy of Pediatrics, and the American Public Health Association.”
Recent evaluations of child-care settings identified through this investigation suggested room for improvement to the nutritional quality of foods provided to children, the amount of time children are engaged in physical activity, caregiver behaviors that may deter healthy behaviors, and missed opportunities for education. Even though a limited number of interventions have been created to address these issues, only 2 interventions displayed evidence of success in reducing risk for obesity among child participants.
Some of the nutritional guidelines available to the child-care provider are discussed by Margaret Briley. PhD, RD, LD, and Michael McAllaster, both of the Department of Nutritional Sciences, The University of Texas at Austin, in an associated review. Stating that child-care facilities receiving financing from the Child and Adult Food Care Program (CACFP) must follow CACFP guidelines for healthy foods and snacks, but that they may differ from recommendations from professional associations, such as the American Pediatric Association or the American Dietetic Association. However, they identify that the child-care setting can play a crucial role in encouraging health eating habits.
According to Briley and McAllaster:
“In the past 3 decades, child-care centers have replaced the family table as the learning environment for young children’s food habits. America is facing the reality that many children younger than 5 years can be classified as obese or overweight.
Research has discovered that one in three children under 5 in low income families is obese or overweight. The greatest impact on obesity can be made among this population and assure that the next generations have eating and exercise habits that support a life of good health as well as reduced medical costs. Parents must become advocates for their children’s food intake and support policy changes that strengthen nutrition programs that will enable all children to eat nutritious meals and snacks that support a lifetime of good health.”
In an accompanying podcast Dr. Larson and Dr. Ward share their insights about how child-care settings can play an important role in establishing healthy eating and exercise habits in preschool children and update the results of their study taking legislation into consideration.
Written by Grace Rattue