By Audrey DeSilva, MD
The prevalence of childhood overweight and obesity has doubled in the past two decades, according to the Centers for Disease Control and Prevention. Nearly 16 percent of children and adolescents in the United States are now overweight. Equally alarming is the trend for overweight children to grow into overweight and obese adults. In a call to action in 2001, the Office of the Surgeon General predicted that preventable chronic illness and premature death from complications associated with obesity might surpass even those health problems associated with cigarette smoking.
The current body of knowledge about pediatric obesity is somewhat limited, primarily because the trend is comparatively new. We do know, however, that childhood obesity is on the rise, that it poses serious long-term health risks, and that prevention plays a key role in addressing the problem. Adults who have struggled to lose excess weight are acutely aware of how difficult it can be to achieve lasting weight-loss results by dieting. There is no pill or quick cure for obesity, so the best strategy is preventing it from occurring in the first place.
There are many factors contributing to pediatric obesity. Among these are family history, the increasing consumption of “fast food” that is high in calories and fat, increase in portion sizes, a widespread reduction in the amount of physical activity among even young children, and an increase in sedentary “screen time” (televisions, computers screens, video games). Parents should explore these risk factors as they pertain to their own children, and talk with their pediatricians.
Some Practical Advice for the Early Years
Following are some observations about early childhood eating and nutrition, and some practical steps you can take as the parent of a young child to prevent obesity.
- We encourage mothers to breastfeed as long as possible in the first year. It is very difficult to overfeed a breastfed baby and there is some research that suggests breastfeeding is protective against obesity.
- In many cultures, eating and nurturing are synonymous. Some parents calm their upset babies with food, at which point food becomes an agent of comfort, not nutrition. Make sure the reason the baby is crying is due to hunger, and not just the desire to be held or changed. By all means, if the baby is hungry, feed her.
- In the first 12 months, babies grow very rapidly and require frequent feeding. Around the age of one year, they become more active, but at the same time there is a decrease in growth velocity. Proportionate to their weight, they require fewer calories than they did as infants, which is a normal, healthy development.
- Parents find it difficult when their toddlers won’t eat. However, multiple studies show that healthy young children have a very reliable internal mechanism that appropriately regulates their intake of calories and nutrition. Learn to trust your child’s innate ability to eat as much as he or she needs.
- In toddlers, satiety signals are quite good. Your 2-year old may feel full after just a couple of bites, and that’s fine. The most practical house rule is that the parent gets to choose when and what to feed the child, and the child gets to choose how much of it to eat. Often toddlers eat only one significant meal a day, and take only a bite or two at other meals.
- Offer your toddler a variety of food choices. If he’s hungry, he’ll eat. If he is not hungry, the food will sit there. Put food in front of him that he’s eaten before. If he doesn’t eat it, don’t offer more options to get him to eat something or you may end up with a picky eater.
- Sweets should not be a major part of the diet, but an occasional sweet is fine. If dessert is part of the meal, don’t require your child to clean his plate in order to have it. Holding out one kind of food as a reward is not a good idea and may confuse the child as you try to instill good eating habits.
- Make active play a regular part of every day and limit screen time to less than two hours a day.
Dr. DeSilva is board certified in pediatrics and is on the medical staff of Cayuga Medical Center. She is in practice with Northeast Pediatrics and Adolescent Medicine, where she can be reached at (607) 257-2189.