How can <strong>Ontario</strong> create a present anda future where our children lead trulyhealthy, fulfilling lives? Where they...●● have the best start in life●● are loved and valued●● are surrounded by supportive families and friends●● feel good about themselves, and know how <strong>to</strong> cope withstresses and challenges in life●● feel safe and part of their communities●● know about healthy eating, have easy access <strong>to</strong> healthyfoods, and make healthy food choices●● have time every day <strong>to</strong> play and be active●● get enough sleep●● have the health services they need●● are prepared for a future full of opportunities.<strong>Ontario</strong> should focus onthree areas that will make asignificant difference in ourchildren’s weight and health:1. Start all kids on the path<strong>to</strong> healthGood health begins even before babies areconceived. <strong>Health</strong>y mothers have a muchbetter chance of having babies who enjoygood health throughout their lives. We mustprovide the support young women need <strong>to</strong>maintain their own health and start theirbabies on the path <strong>to</strong> health.2. Change the food environmentParents know about the importance of goodnutrition. <strong>The</strong>y are aware that their kidsshould be eating lots of fresh fruits andvegetables, less sugar and fewer high-caloriesnacks or processed foods. Parents <strong>to</strong>ld usthey try <strong>to</strong> provide healthy food at home, bu<strong>to</strong>ften feel undermined by the environmentaround them. <strong>The</strong>y want changes that willmake healthy choices easier.Why focus on food?To have the greatest impact on weight, wemust focus on healthy eating. On average, weare all consuming <strong>to</strong>o many calories – aboutthe equivalent of one extra meal – every day.It’s almost impossible <strong>to</strong> be active enough<strong>to</strong> burn off that many extra calories. Havingsaid that, being physically active is also animportant part of being a healthy kid.3. Create healthy communitiesChildren’s health does not begin and endwith what they eat. <strong>Kids</strong> live, play and learnin their communities. Many policies andprograms affect kids’ ability <strong>to</strong> eat welland <strong>to</strong> be active. Communities must work<strong>to</strong>gether <strong>to</strong> improve child health. We needa comprehensive all-of-society approach<strong>to</strong> create healthy communities and reduceor eliminate the broader social and healthdisparities that affect child health.24
1. Start All <strong>Kids</strong> on thePath <strong>to</strong> <strong>Health</strong>RationaleChildren who start life at a healthy weightare more likely <strong>to</strong> grow up <strong>to</strong> be healthyweightadults. To start all kids on thepath <strong>to</strong> health, <strong>Ontario</strong> should focuson interventions that target women andchildren during preconception, the prenatalperiod and infancy. <strong>The</strong>se are the life stageswhere we can have the greatest long-termimpact on health and weight. 94From preconception <strong>to</strong> infancy iscritical <strong>to</strong> long-term healthFor their own health and well-being, it isimportant for women <strong>to</strong> eat healthy foods,be active, get enough sleep, avoid smoking,have supportive friends, enjoy life, feel goodabout themselves and maintain a healthyweight. It is also important for their babies.A woman’s health and weight before shebecomes pregnant and her weight gainduring pregnancy have a direct influenceon her child’s health and weight.●●●●Behaviours such as smoking duringpregnancy are associated with low birthweight – and babies with low birthweight can experience rapid catch-upwhich can lead <strong>to</strong> later obesity. 95Being overweight or obese beforepregnancy and excessive weight gainduring pregnancy can be accompanied●●<strong>The</strong> best nutritional start for babies 94●●●●●●●●●●Breastfeeding<strong>No</strong> solid food until six monthsA variety of fruits and vegetables every dayOnly water in the cupBeing part of an active familyby a rise in blood sugar levels (gestationaldiabetes), which can cause the fetus <strong>to</strong>grow more quickly – and larger babiestend <strong>to</strong> be heavier in childhood. 96Children of women who gain anexcessive amount of weight duringpregnancy had more than four timesthe risk of being overweight at age 3. 97Between 40 per cent <strong>to</strong> 50 per cent ofpregnant women gain more weightduring pregnancy than the Institute ofMedicine and Society of Obstetricians andGynecologists of Canada recommend. 98Weight gain before and during pregnancy,combined with high rates of diabetes, is aparticular issue for Aboriginal women. 99,100All mothers want <strong>to</strong> give their children thebest start in life, and are motivated <strong>to</strong> makechanges that will protect their child’s health.However, most need information and manyneed support <strong>to</strong> improve their own healthand protect their child’s health. Prenatalprograms provide a unique opportunity<strong>to</strong> promote women’s and baby’s health;however, these programs are provided by amix of public health units, hospitals andprivate sec<strong>to</strong>r organizations. <strong>The</strong>re areno standard provincial guidelines or core2594 Wen, Li Ming, Baur, Louise A, Simpson, Judy M, Rissel, Chris, Wardle, Karen, Flood, Vic<strong>to</strong>ria M. “Effectiveness of home based early intervention onchildren’s BMI at age 2: randomised controlled trial” BMJ 2012; 344:e3732. Australian study, 2012.95 KS Gibson, TP Waters, PM Catalano. (2012). Obstetrics & Gynecology, 2012.96 Parket M, Rifas-Shiman SL, Oken E, Belfort MB, Jaddoe VW, Gillman MW. (2012). Second trimester estimated fetal weight and fetal weight gainpredict childhood obesity. J Pediatr <strong>No</strong>v; 161(5):864-870.e1.97 Oken E, Tavares EM, Kleinman KP, Rich-Edwards, Gilman MW. (2007). Gestational weight gain and child adiposity at age 3 years. Am J ObstetGynecol196:322.e1-8.98 Schieve LA, Cogswell ME, Scanlon KS. (1998). Trends in pregnancy weight gain within and outside ranges recommended by the Institute of Medicinein a WIC population. Matern Child <strong>Health</strong> J. 2(2):111-6.99 Lowell H and Miller DC. (2010). Weight gain during pregnancy. Statistics Canada, Catalogue no. 82-003-XPE. <strong>Health</strong> Reports, Vol. 21, no. 2.100 Public <strong>Health</strong> Agency of Canada. (2011). Diabetes in Canada: Facts and figure from a public health perspective. Ottawa. p. 92.