To tackle childhood obesity, focus more on pregnancy and infancy

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Childhood obesity campaigns such as First Lady Michelle Obama’s ‘Let’s Move’ program are good, but they may not be enough to truly stem the tide of obesity, according to a perspective article published online Wednesday in the New England Journal of Medicine.

There’s no doubt that school and home interventions focusing on nutrition and exercise are helpful, and more attention is being paid to improving school lunches and encouraging physical activity. But some studies show that those efforts may be too little too late, say the paper’s authors, Janet Wojcicki and Dr. Melvin B. Heyman of the department of pediatrics at UC San Francisco, who make a strong case that more importance needs to be placed on pregnancy and infancy.

Too many overweight and obese children are exhibiting ill effects such as high blood pressure and early signs of heart disease by the time they’re in school. And that doesn’t bode well for later years. ‘[P]revention must start as early as possible,’ the authors wrote, ‘since school-age children already have an unacceptably high prevalence of obesity and associated medical conditions.’ This topic was covered in depth by Times health writer Shari Roan.

Issues that should be targeted include excessive maternal weight gain, smoking during pregnancy and truncated breast feeding. ‘Studies have shown,’ the authors wrote, ‘that early interventions can potentially prevent the development of obesity in school-age children, along with associated health conditions.’

Wojcicki and Heyman point out that attempts are being made to address this critical period, such as stop-smoking campaigns and the Institute of Medicine’s stricter guidelines for pregnancy weight gain for obese women. But they add, ‘The Let’s Move campaign could synchronize its efforts more directly with these existing campaigns and try to ensure that the IOM recommendations are more widely known and followed by pregnant women.’

-- Jeannine Stein