|Child-care facilities can do more to promote preschoolers’ healthy eating and physical activity|
|September 01, 2011|
What children eat and how physically active they are can shape their eating and activity habits as adults. Researchers from the University of North Carolina at Chapel Hill recently published research that evaluates research describing opportunities and strategies to prevent obesity among preschool-age children in child-care settings.
Dianne Ward, EdD, professor of nutrition at the UNC Gillings School of Global Public Health and research fellow at the UNC Center for Health Promotion and Disease Prevention (HPDP), co-authored the review article, which appears in the September 2011 issue of the Journal of the American Dietetic Association (JADA). The review found the need for improvement regarding the nutritional quality of foods provided to children, amount of time children are engaged in physical activity, caregiver behaviors that may discourage healthy behaviors, and missed opportunities for education.
Ward leads several projects focused on preventing obesity in preschool children, including NAP SACC, a program recently recommended by Michelle Obama's Let's Move! campaign as a way to combat obesity in child care centers. Ward joined other experts from the University of Minnesota School of Public Health, the University of North Carolina at Chapel Hill's Gillings School of Global Public Health, and the Duke University Medical Center in conducting the review. The work was funded by Healthy Eating Research, a national program of the Robert Wood Johnson Foundation.
"The prevention of obesity should begin early, and child-care environments provide promising settings for developing appropriate eating and physical activity behaviors," Ward said. "Healthy weight development in during childhood can help prevent the numerous health problems associated with excessive weight gain during the childhood years and contribute to the prevention of other health problems throughout in the adult years."
Ward noted that more than 60 percent of mothers with young children work outside the home and use some type of out-of-home care. "Of children who attend child-care facilities," she said, "many spend several days each week and many hours in these settings, highlighting the importance of providing healthy foods and regular activity, as well the promotion of healthy behaviors. However, to support the development of health-promoting eating and activity behaviors will require the adoption of strong policies and the use of evidence-based programs to reinforce their development."
Conducting a comprehensive review of the research literature, investigators identified and assessed 42 relevant studies that can serve as baselines against which future progress may be measured. These included four reviews of state regulations, 18 studies of child-care practices and policies that may influence eating or physical activity behaviors, two studies of parental perceptions and practices relevant to obesity prevention, and 18 evaluated interventions. Although research focused on the U.S., interventions implemented in international settings also were included.
While a limited number of interventions have been designed to address the concerns of quality of food, amount of time for physical activity and caregiver behaviors, only two interventions showed evidence of success in reducing risk for obesity among child participants.
Child-care facilities in the U.S. primarily are regulated by individual states. Each state establishes its own set of regulations for licensed child-care facilities and sets minimum enforcement standards to assess compliance. However, recent reviews indicated there is a gap between existing state regulations for child-care settings and the standards recommended by public health experts. Most states lacked strong regulations related to healthy eating and physical activity. There was strong variation among states in promoting eight key nutrition and physical activity measures in child-care settings. For example, while Tennessee covered six of the eight factors, the District of Columbia, Idaho, Nebraska and Washington had none.
Ward and co-author Nicole Larson, PhD, MPH, RD, research associate in the University of Minnesota's Division of Epidemiology and Community Health, 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 in a podcast available on the JADA website.
Alice Ammerman, DrPH, director of the HPDP and professor of nutrition at the UNC public health school, was interviewed about the review article and quoted in an article on WebMD.
|Last updated September 01, 2011|