From USA Today:
Each of the children in Betty McNear’s home day care has a paper cup with their name neatly written on it and a green bean or pepper plant sprouting inside.
The preschoolers help set the lunch table and clean up afterward, eating a “rainbow” of foods in between. They study their colors with tomatoes and blueberries and learn to share by preparing a meal to feed everyone.
McNear’s approach at My Nana Too, a family child care center she owns and runs in Garfield Heights, Ohio, is more than an academic exercise. It’s also a bulwark against obesity and the lifelong health risks it can bring.
Her “kids” grow up knowing what a balanced diet looks like, how much is an appropriate portion and why it’s important to favor fruits and vegetables over ultra-processed fast food.
For four decades, Americans have essentially thrown up their hands in the face of this growing epidemic, bemoaning the problem and lack of solutions.
But slowly, responses have been cropping up around the country. Some are as small as a pepper plant in a paper cup. Others are as large as an overhaul of the school lunch program, which is finally combating obesity rather than contributing to it.
Will they be enough?
It’s too soon to tell, experts say, but the path to addressing widespread obesity has to start in childhood when habits are established, lessons learned and capping weight gain remains realistic.
“If we can put our resources into prevention, it’s going to go much further in the longer-term than waiting to treat someone,” said Christina Economos, an expert in pediatric obesity and behavior change and interim dean of the Friedman School of Nutrition Science at Tufts University. “The only way is starting early.”
More than half of adolescents with obesity had met the criteria by age 5, according to one 2018 study. And adolescents were more likely to have obesity if they were relatively large at birth, the study found, meaning risk starts before a child is even born.
People tend to become more sedentary as well as heavier with age – a combination that can lead to the health problems that have made Americans among the unhealthiest of the world’s wealthy populations, plagued by diabetes, high blood pressure and premature death.
In Cuyahoga County, where McNear lives and runs her day care, nearly 1 in 4 preschoolers fit the medical definition of having obesity or overweight. For children of color, it’s roughly 1 in 3.
One in 10 already have blood pressure problems, according to Alison Patrick, a program manager with the Cuyahoga County Board of Health. The situation only got worse during the pandemic, she said.
No one actually knows what happens to the health of children who have obesity and high blood pressure before they graduate from kindergarten. Obesity in early childhood hasn’t been a major concern long enough to have tracked these kids across the lifespan.
But it’s not likely to be good.
“The longer (these problems) exist and persist, the more damaging they’re going to be,” said Dr. William Dietz, who directs the Sumner M. Redstone Global Center for Prevention and Wellness at The George Washington University in Washington, D.C.
“The older you get and the more severe the obesity you have in childhood, the more likely it is to persist into adulthood.”
The COVID-19 pandemic made life harder for children in many ways. Not surprisingly, it also led to weight gain.
From 2019 to 2020, obesity increased by 6% among elementary school children, according to a study – multiple times the typical annual increase, Dietz said.
Kids who started out with disadvantages because of race, income or existing obesity gained the most weight, the study found. Black and Hispanic children added more pounds than white kids and girls more than boys. Children who started out carrying extra weight were likely to have gained the most.
Although it hasn’t been extensively studied, Dietz expects school-age children gained the most during the pandemic because they were too young to go out on their own. They lacked the structure of school and missed the healthy meals and physical activity provided there.
Among 700 children in a study at the Cambridge Health Alliance in Massachusetts, almost all gained weight during the pandemic, but children ages 2 to 5 added more than older kids, as did Spanish-speaking and Brazilian children, said Dr. Wudeneh Mulugeta, a preventive medicine specialist who led the research.
Traumatic experiences, which many children endured during the pandemic, are strongly associated with unhealthy weight, said Dr. Brian Jenssen, a primary care physician and researcher at the Children’s Hospital of Philadelphia and the University of Pennsylvania.
Perhaps children gained weight during the pandemic in part because giving them something delicious to eat was one of the few ways parents could give them pleasure at a difficult time, Jenssen said.