Early Childhood Education

Obesity

The World Health Organisation has identified obesity as the most visible preventable health condition related to illness and premature death worldwide. Many experts in the fields of child health and nutrition have identified childhood obesity as a critical health issue for this millennium. The dramatic growth of childhood obesity both internationally and within the United States parallels the increase in the prevalence of adult obesity. The prevalence of overweight in the United States among two- to five-year-old children has doubled during the past thirty years. High prevalence rates (some studies suggest as many as 28%) of obesity in low-income preschool children are especially alarming. This epidemic appears to be the result of many interrelated factors associated with the American culture, including increased serving sizes, increased availability of junk food, unhealthy school lunches, inadequate school physical education, scarcity of safe playgrounds, busy parents and increasing television, video game, and computer usage. While researchers were initially concerned that overweight and obesity in childhood would lead to health-related problems and disabilities in adulthood, it is now clear that there are significant health risks associated with obesity in children. Associated health risks during childhood include elevated blood pressure, orthopedic impairments such as hip and joint pain, liver disease, and diabetes. In fact, it appears that there are few organ systems that are not adversely affected by obesity in childhood, and the consequences begin during childhood.

The significant impact of childhood obesity is not limited, however, to physical, orthopedic, and skeletal problems. “The most widespread consequences of childhood obesity are psychosocial. Obese children become targets of early and systematic discrimination” (Dietz, 1998, p. 518). Widespread harassment of overweight children and weight stereotyping has been shown to begin as early as nursery school and continue throughout childhood. This rejection as well as discrimination from their peers causes young children with obesity to have poor self-esteem and may lead to depression and withdrawal, decreased physical activity, and increased emotion-induced eating. A vicious cycle is often created in which children who are overweight or obese avoid play, particularly active play situations, fearing embarrassment, thus avoiding the very type of physical activity that would increase caloric expenditure and reduce or limit weight gain. Instead, such children are more often engaged in solitary and sedentary activity.

To change the behaviors of young children, interventions with schools and parents are critical. Indeed, respectful and ongoing relationships with families may be the most important component in the success of obesity prevention programs for preschoolers for multiple reasons. Parents influence the dietary behaviors of their children by acting as role models and teaching their children about food. The ways in which parents offer food to their children, or their child feeding practices, also influence the subsequent eating behaviors of their children. For example, child feeding practices such as pressuring children to eat healthy foods or restricting them from eating less healthy foods, have been associated with increased preferences for the restricted foods, increased dietary intake, decreased self-regulation of food intake, and increased body weight in children. Parents also play a role in the development of the activity patterns of their children by acting as role models, being physically active with their children, and encouraging or discouraging activity. When both parents are active, a child is almost six times more likely to be active than if neither parent is active (Moore et al., 1991).

Early childhood educators serve a critical role in educating the child as well as the family regarding the necessity of a healthy lifestyle. In addition, it is critical for early childhood educators to create a supportive environment for children of all sizes and shapes. By focusing on health as opposed to weight, early childhood educators create an environment in which all children feel safe to be physically active and to eat healthy. Early childhood educators can create school environments that involve developmentally appropriate physical activity, including opportunities for play and a physical education curriculum, familiarity with basic nutrition, and acceptance of body diversity. Within the context of the early childhood curriculum, young children can be taught how to garden, how to do basic food preparation, how to actively play, and how to communicate positively with one another. Early childhood educators can also educate parents on topics that facilitate a healthy lifestyle such as goal setting, time management, stress management, communication, and appropriate reward systems. Parents should be encouraged to eat as a family as this is associated with better nutrition and stronger communication. Parents and early childhood educators should also minimize the use of food as a reward or strategy for behavior management, as this may encourage a preference for that food as well as an unhealthy association between emotional needs and foods. Finally, early childhood educators and parents should examine their own behaviors as they serve as role models to children.

The increasing rates of obesity in our youngest children necessitate a collaborative effort between early childhood professionals and family members to instill healthy behaviors in children at a young age. The focus on healthy behaviors such as nutrition and physical activity, along with self-esteem, are the cornerstones of obesity prevention. Prevention is the most effective way to affect the prevalence of obesity and requires immediate action. See also Curriculum, Physical Development; Developmentally Appropriate Practice(s); Parents and Parent Involvement; Peers and Friends.

Further Readings: Birch, L. L., D. W. Marlin, and J. Rotter (1984). Eating as the “means” activity in a contingency: Effects on young children’s food preferences. Child Development 55, 431-439; Dietz, W. H. (1998). Health consequences of obesity in youth: Childhood predictors of adult disease. Pediatrics 101(3 Pt 2), 518-525; Hood, E. (2005). Sharing solutions for childhood obesity. Environmental Health Perspectives 113(8), A520-A522; Huettig, C. Adapted Physical Education, Project Inspire. Available online at www.twu.edu/inspire. Huettig, C., S. S. Rich, J. Engelbrecht, C. Sanborn, E. V. Essery, N. DiMarco, et al. (2006). Growing with EASE: Eating, activity, and self-esteem. Young Children, Journal of the National Association for the Education of Young Children 61(3), 26-30. Moore, L. L., D. A. Lombardi, M. J. White, J. L. Campbell, S. A. Oliveria, R. C. Ellison (1991). Influence of parents’ physical activity levels on activity levels of young children. Journal of Pediatrics 118(2), 215-219; Stolley, M. R., M. L. Fitzgibbon, A. Dyer, L. Van Horn, C. K. Kaufer, L. Schiffer (2003). Hip-Hop to Health Jr., an obesity prevention program for minority preschool children: Baseline characteristics of participants. Prev Med 36(3), 320-329; World Health Organisation (2003). Information sheet. Obesity and overweight. Geneva, Switzerland: WHO. Available online atwww.who.int/dietphysicalactivity/media/en/gsfs_obesity.pdf.

Shannon S. Rich, Charlotte Sanborn, Nancy DiMarco, and Eve Essery