In the battle against childhood obesity, start young(er than you think)

Claire McCarthy, MD

We all know that prevention is the best way to deal with any public health problem. With obesity being an increasingly, um, huge problem in our society, we need to do everything we can to prevent it. And to do so we need to start in—infancy?

That’s the message in the study by Children’s Hospital Boston researchers in this week’s journal Pediatrics. As described yesterday in Tripp Underwood’s Thrive post, the study, led by Susanna Huh, MD, MPH, and Sheryl Rifas-Shiman, MPH, showed that when parents of formula-fed infants started solid foods before 4 months of age, the infants were six times more likely to be obese at age 3.

Why do we care? Three is very far from adulthood. There’s still plenty of time to lose the baby fat. Right?

Well, the problem is that it’s becoming increasingly clear that baby fat leads to adult fat. Obese toddlers are more likely to grow into obese children, and obese children are more likely to grow into obese adults. One study showed that nearly half of obese adolescents will be severely obese by the time they’re 30. And with obesity comes heart disease, hypertension, diabetes, orthopedic problems, a higher risk of certain cancers—and all sorts of social, emotional, and even economic difficulties.

So to give children their best shot at a healthy future, parents need to start early. Actually, they need to start before they’re even born: a study from last year, by David Ludwig, MD, PhD, director of Children’s Optimal Weight for Life Program (who last week got $7 million from the New Balance Foundation to study and treat childhood obesity), and other researchers showed that gaining too much weight during pregnancy can lead to overweight babies. Smoking during pregnancy can do it too.

Here’s what parents of infants and toddlers can do:

  • Breastfeed. Interestingly, in the Pediatrics study, starting solids early didn’t lead to obesity in infants who were breastfed for at least four months. Many other studies have shown that breastfed babies are less likely to become obese children. Every drop counts, but breastfeeding for as close to 12 months as possible is best.
  • Don’t start solid foods until at least 4 months. Six months might even be better. As fun as it is to feed them, babies don’t need solid foods early, and early solid foods can lead to the rapid weight gain that puts children at risk of obesity.
  • Limit the juice. Kids don’t need juice, plus it’s extra calories—better to not even start the juice habit. If you do give it, limit it to 4 ounces of 100% juice (none of that sugared stuff!) a day.
  • Embrace fruits and vegetables. Tastes develop early. This is your chance to convince your child that carrots are amazing and strawberries are just as good as chocolate!
  • Watch the snacking. I, too, have carried around bags of snacks to distract my children as toddlers. There’s nothing wrong with this, but be careful not to create the habit of grazing all day, especially on things like crackers and cookies. Have designated times for meals and snacks, and try to make snacks as healthy as possible.
  • Turn off the TV. As with juice, don’t even start the habit. The American Academy of Pediatrics recommends that children under the age of 2 not watch television, for all sorts of good developmental and behavioral reasons. And a 2005 study in the British Medical Journal showed that children who spent eight hours a week watching TV at age 3 were more likely to be obese at age 7.

    Dancing with your kids is a great way to get the whole family moving.
  • Get physical! Make it a point to do some physical play with your child every day. Play on the floor with your infant, go to family swim, go for a walk. Going for a walk is a good idea even if your child can’t walk; it gets him or her used to the idea of going for a walk, and it gives you some exercise. Which leads to my final suggestion…
  • Get healthier yourself. Children of overweight parents are far more likely to be overweight themselves. Some of it is genetic, but let’s be honest: a lot of it is related to the eating and exercise habits of the family. Set a good example for your children (and feel better as you do!)

Small changes can make a big difference when it comes to prevention. So start today with something small, like a dancing session in the living room, or cut-up grapes for a snack. You will be helping your child have a healthier future.