Preventing Childhood Obesity - Evidence Policy and Practice.pdf

CHAPTER 29
Obesity in e arly c hildhood and w orking in
p re - s chool s ettings
Andrea M. de Silva - Sanigorski, 1,2 Camila Corval á n 3 and Ricardo Uauy 4,5
1 WHO Collaborating Centre for Obesity Prevention, Deakin University Geelong, Australia
2 Jack Brockoff Child Health and Wellbeing Program, The McCaughey Centre, Melbourne
School of Population Health, The University of Melbourne, Melbourne, Australia
3 School of Public Health, University of Chile, Santiago, Chile
4 Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
5 Nutrition and Public Health Intervention Research Unit, London School of Hygiene and
Tropical Medicine, London, UK
Summary and recommendations
for research and practice
• The new WHO growth standards for children aged
0 – 5 years are a major improvement on previous
reference standards.
• The risk of obesity is related to children ’s growth,
development, behaviors and environments in the
early years of their lives.
• Appropriate nutrition requirements should be used
to guide education directed at parents of infants,
and policy - based requirements are needed in care
settings.
• With more young children going into child care
earlier, it is important that there should be regulation
regarding the nutritional quality of the foods
and drinks provided, and the opportunities for
physical activity in these settings.
• Adequate structured and unstructured active play is
needed for children to maintain a healthy weight
and also to develop the skills needed for lifelong
participation in physical activity.
• Physical inactivity is also an issue in young children
and strategies to limit or reduce screen - based activities
in the home and child care settings are needed.
Preventing Childhood Obesity. Edited by
E. Waters, B.A. Swinburn, J.C. Seidell and R. Uauy.
© 2010 Blackwell Publishing.
Introduction
This chapter examines several issues on obesity in
early childhood that have direct practical relevance to
supporting healthy weight gain in this critical period
of life. The first fundamental issue for child health
nursing practice is the definition of normal growth in
early childhood, which leads directly into an examination
of the assessment of at - risk growth patterns and
other risk factors for later childhood (and adult)
obesity. Appropriate feeding practices are fundamental
to healthy weight gain in early childhood and these
recommendations are reviewed as well as the importance
of active play, motor skill development and
reduced television viewing time. Patterns for all
human behaviors are highly influenced by environments,
and this is most true in the early childhood
years. Thus, the many preschool settings outside the
home environment are also examined as opportunities
for implementing the policies and practices
needed to promote healthy eating and active play.
Growth and e xcess w eight
a ssessment in e arly c hildhood
Historically, good health and nutrition in childhood
have been defined by the capacity to support normal
growth. Existing national and international standards
have defined normal growth based on the weight and
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