July/Aug. 2011 - The Latest Report on Childhood Obesity: Sleep is Important to Weight Control
Staff Report
Even the youngest children in the United States are at risk of becoming obese. Today, almost 10 percent of infants and toddlers carry excess weight for their length, and slightly more than 20 percent of children between the ages of two and five are already overweight or obese. Because early obesity can track into adulthood, efforts to prevent obesity should begin long before a child enters school.
We can’t blame this on school lunch programs – they’re not in school yet. The problems are occurring at home according to a June report by the The Institute of Medicine (IOM) on this critical topic and at childcare facilities.
The IOM reviewed factors related to overweight and obesity from birth to age five, with a focus on nutrition, physical activity, and sedentary behavior, and made recommendations that healthcare professionals, caregivers, and policymakers can take to prevent obesity in children five and younger.
Pediatricians and other healthcare professionals have an important opportunity to make parents aware of their child’s excess weight early on, and the IOM recommends that healthcare professionals measure weight and height or length in a standardized way, as well as pay attention to obesity risk factors, such as rate of weight gain and parental weight, at routine pediatric visits.
But if your pediatrician is not confronting you with the issue, as a parent, there is a lot you can do to help your children on your own.
The IOM recommends that parents and child care providers keep children active throughout the day and provide them with diets rich in fruits, vegetables, and whole grains, and low in energy-dense, nutrient-poor foods. It’s also important that caregivers limit young children’s screen time and ensure that children sleep an adequate amount each day.
What happens to children during the first years of life is important to their current and future health and well-being. Quality sleep is an important aspect of the obesity problem and preschoolers (aged two-five) should watch TV or video games no more than one hour a day.
While a lot of the report is directed at physicians and caregivers, it also contains information that parents can enact on their own, and it helps parents understand what their pediatrician is looking for – or should be looking at – when conducting your child’s check-up.
The report states that healthcare providers should measure weight and length or height in a standardized way, plotted on World Health Organization growth charts (ages 0-23 months) or Centers for Disease Control and Prevention growth charts (ages 24-59 months), as part of every well-child visit.
Your pediatrician should consider 1) children’s attained weight-for-length or BMI = 85th percentile, 2) children’s rate of weight gain, and 3) parental weight status as risk factors in assessing which young children are at highest risk of later obesity and its adverse consequences.
Parents should practice what is called ‘responsive feeding.’ This means:
• For infants: holding infants in one’s arms or sitting up on one’s lap while feeding, and not propping bottles; recognizing infant feeding cues (e.g., rooting, sucking); offering an age-appropriate volume of breast milk or formula to infants and allowing infants to self-regulate their intake; and introducing developmentally appropriate solid foods in age-appropriate portions, allowing all infants to self-regulate their intake.
• For toddlers/preschoolers: providing meals and snacks as part of a daily routine; requiring adults to sit with and eat the same foods as the children; when serving children from common bowls (family-style service) allowing them to serve themselves; when offering foods that are served in units (e.g., sandwiches) providing age-appropriate portions and allowing children to determine how much they eat; and reinforcing children’s internal cues of hunger and fullness.
Sleep Is Important to Weight Control
Parents need to:
• Create environments that ensure restful sleep, such as no screen media in rooms where children sleep and low noise and light levels during napping
• Encourage sleep-promoting behaviors and practices, such as calming nap routines
• Use practices that promote child self-regulation of sleep, including putting infants to sleep drowsy but awake
• Seek consultation from an expert on healthy sleep durations and practices if you are experiencing problems getting your children to sleep.
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