Focus on early childhood to prevent weight gain, IOM report says


Childhood obesity may be a hot-button health issue, but weight-related problems may begin before children start preschool. A new report, “Early Childhood Obesity Prevention Policies,” from the Institute of Medicine released Thursday puts the spotlight on infancy and the toddler years, suggesting that child care providers, government programs and physicians be vigilant, noticing when kids are too large for their size, and promoting more activity and healthful behaviors to stop very young kids from gaining too much weight.

“It’s really emerging that this period of time presents an opportunity to really make a difference in terms of wellness and healthy weight,” said Dr. Wendy Slusser, medical director of the Fit for Health program at Mattel Children’s Hospital UCLA. Slusser, who was on the committee that issued the report, added, “It’s an area that hasn’t been focused completely in such a comprehensive way.”

Adulthood, she added, may not be the best time for an intervention. “You’re usually not very successful,” she said. “Certainly an overweight or obese child has a higher risk of being an overweight or obese adult, so if we can catch them at an earlier time maybe we’ll be more successful.”


If it takes a village to raise a child, it may take the same village to make sure that child eats well, gets enough sleep and doesn’t spend hours vegging out in front of the television or computer. While the report acknowledges that parents typically affect their children’s health the most, mom and dad aren’t the only ones who hold sway.

The report offers several recommendations, starting with having babies and toddlers measured for weight and length at every regular pediatric or well-child visit. The idea here is to give parents a heads up if their child’s weight is beginning to creep up so they can act accordingly. The report suggests using updated growth charts from the World Health Organization and the Centers for Disease Control and Prevention to monitor children’s weight gain.

Child care providers and teachers need to make sure young children get enough physical activity, the report says. Those authority figures also need to clue parents in on how their kids can get more exercise and stay clear of the couch. Diet is part of this scenario as well--since food preferences can develop early, the more children are exposed to healthful foods, such as whole grains and fresh fruits and vegetables, the better. Breastfeeding should be promoted too.

The Dietary Guidelines for Americans (put out by the U.S. Department of Health and Human Services and the U.S. Department of Agriculture) don’t include suggestions for children younger than age 2 -- but it should, the study argues, since that is a critical time in a child’s development.

Children’s screen time should be limited because kids are a favorite target of food and beverage marketers who consider them a valuable audience. They recommend healthcare providers advise parents to keep televisions and other forms of media out of their young children’s bedrooms.

Not getting enough sleep may be a risk factor for obesity, so childcare providers should ensure adequate sleep time, and healthcare professionals need to talk to parents about how much sleep their children get.

“Doctors are certainly considered very trusted sources,” Slusser said, “and day care providers are also on that list. ... With these policy recommendations we’re trying to provide guidance and support and influence policy so we can support these positive behaviors in early childhood years.”