Child Care is a Key Ally in Childhood Obesity Fight: Know What's for Lunch
"They need to be asking, what goes on, and what are the kids being fed?"
The problems of childhood obesity can be overwhelming to parents. They read that it is a national epidemic threatening this generation of children with health issues, ranging from heart problems and type 2 diabetes to shortened life spans and high cholesterol.
The reality is that childhood obesity is a major U.S. health problem, one that doctors, leading medical groups, the federal government and parents are concerned about and working on. Childhood obesity rates tripled over the last 30 years[i], although rates stabilized in recent years; and a third of children born this century will struggle with diabetes, according to First Lady Michelle Obama’s new campaign to address the problem. Today, as many as one in five children are obese.[ii]
To begin solving the problem, University of Washington researchers have shown it’s important to start with some of the nation’s youngest eaters, and that means focusing on the child care programs many attend.
Why? Today, more than 80 percent of children under age five spend time in child care, preschool or other non-parental care[iii], and the quality of food in these programs varies widely, ranging from broiled chicken and fresh vegetables to pre-packaged low-nutrition lunches.
Inside and outside child care, the sad fact is many children are now overweight - 18 percent of the nation’s 4-year-old children are obese[iv], according to “Why Child Care Matters for Obesity Prevention,” an issue brief published by the University of Washington Center for Public Health Nutrition.
The brief is part of a broader effort the UW center launched in 2006, with a grant from the Robert Wood Johnson Foundation, to understand how different types of child care effect obesity. They learned, for example, children who attended licensed child care programs or were cared for by their parents were less likely to start kindergarten obese than children in child care offered by extended family, friends and neighbors.[v]
The UW team not only studied the issue, they launched a campaign in 2009 to help parents take control of their child’s nutrition with a series of issue briefs.
“Parents need to re-establish their power as parents. They should not be afraid to say no to requests for unhealthy foods,” says Donna Johnson, associate director of the UW Center for Public Health Nutrition and the architect of the issue briefs. “They are pushing upstream against relentless marketing of less healthy foods.”
How Child Care Fights Obesity
High-quality child care programs that serve healthy snacks and meals can make that push easier by helping to lay a foundation for healthy eating habits, UW researchers explain in “Best Practices for Nutrition, Physical Activity and Screen Time in Child Care Settings.”
One big problem, though, is preschoolers too often don’t get up and play in child care. Preschoolers were sedentary for 90 percent of the day and spent only 3.4 percent of the day in moderate or vigorous exercise, one study found.[vi]
Child care directors can get kids moving by simply adding portable play equipment because research shows this significantly increases physical activity for boys and girls age 3 to 5.[vii] Of course, equipment will not help if students don’t use it. The UW team recommends 30 to 60 minutes of swinging, jumping, climbing and other age-appropriate physical activity and play every day.
When they are not on the playground, children should keep crawling, stretching and jumping. UW researchers recommend teachers incorporate these activities throughout the day.
Children should also play an active role at mealtimes. Teachers should give them some control over how much and what they eat. Serve food in common bowls and pitchers, so children can select their own portions and watch teachers model healthy eating habits. One of the common misconceptions is that children need large portions.
“Sometimes just two tablespoons of vegetables meet the needs of a young child,” the Center for Public Health Nutrition’s Johnson says.
Television also plays a role in a child’s diet. Research has shown TV viewing in young children is linked to poor nutrition and obesity. Kids younger than two years of age should not watch TV and older kids should be limited to one to two hours a day of non-education media time.
What Can Parents Do?
Wherever their kids spend the day, parents are still the architects of their diet. Mom and dad should research nutrition policies of prospective child care providers and ask if staff members are trained in those policies.
“They need to be asking, what goes on, and what are the kids going to be fed?” Find out what’s for snack and lunch. Ask your child’s teacher if they vary fruits and vegetables by offering new colors and types. Do they typically serve your child water, instead of juice? (The American Academy of Pediatrics recommends strict limits on juice.)
“To me it (juice) is a starter beverage for soft drinks and other sweetened beverages,” Johnson says. “Young children, like all of us, need water when we are thirsty.”
Finally, remember the time-tested rule: If parents prepare healthy meals, their children will eventually eat that food.
“Both parents and teachers are often unnecessarily concerned about providing young children only with foods they will like. If child care centers consistently provide well prepared and attractive nutritious foods to well-rested children who have had adequate physical activity and no non-nutritious foods, the children will learn to eat what they are served,” Donna Johnson says.
Further Reading:
The University of Washington Center for Public Health Nutrition published three issue briefs on child care and obesity:
[i] Let’s Move, Learn the Facts, First Lady Michelle Obama’s campaign for healthier children. (http://www.letsmove.gov/learn-facts/epidemic-childhood-obesity)
[ii] Let’s Move, Learn the Facts, First Lady Michelle Obama’s campaign for healthier children. (http://www.letsmove.gov/learn-facts/epidemic-childhood-obesity)
[iii] U.S. Census Bureau, 2005.
[iv] Andersen SE, Whitaker RC. Archives of Pediatrics & Adolescent Medicine, 2008 Apr; 163(4):344-8
[v] Maher EJ et al. Pediatrics. 2008 Aug;122(2):322-30
[vi] 2 Brown WH et al. Child Development. 2009; 80(1):45-58.
[vii] Hannon JC, Brown BB. Preventive Medicine. 2008 Jun;46(6):532-6
