UI prof targets childhood obesity

COEUR d'ALENE - As a nation the U.S. is not only getting fatter, it's getting fatter at an alarmingly early age. Overweight and obesity in children aged 0 to 5 years is rising for the first time in America's history.

Obesity among infants and children is such a new phenomenon that few studies have focused on this age group, said Laurel Branen, nutrition professor at University of Idaho Coeur d'Alene and nationally recognized expert on feeding young children, age 0-5, in a group setting.

"It wasn't an issue before, so we can't go back and look at 30 years of research," Branen said. "They've never looked at the obese 2 year old, because overweight at that age was an anomaly."

Branen was recently asked to serve on the Institute of Medicine's Committee on Obesity Prevention Polices for Young Children. The committee includes renowned researchers, child care practitioners, pediatricians and policy makers, brought together to shape evidence-based obesity prevention policy.

Early childhood obesity is no longer an anomaly. According to the Center for Disease Control and Prevention, currently about 33 percent of American adults are obese. Among American children 2-5 years of age, 10.4 percent were obese according to the most recent figures from 2007-2008.

While obesity rates for very young children are not yet available, rates determining that children 0-5 are at risk for overweight/obesity are concerning, Branen said.

Obese children and adolescents have increased risk for cardiovascular disease, including high blood pressure, high cholesterol and Type 2 diabetes, and are more likely to become obese as adults. In addition, obese adults are at increased risk for coronary heart disease, cancers and stroke.

Branen and the committee have identified several factors that increase the likelihood of very early obesity, including the amount of time a young child spends in front of a variety of screens. Increased weight is directly associated with screen time.

"Some inappropriate habits are being established in early childhood," Branen said. "About 3 or 4 years ago a study was done by the American Dietetic Association that found a high percentage of children and teenagers with TVs and refrigerators in their rooms. Now, they're finding that's true for children ages 0-5."

"As long as a parent keeps the fridge stocked, there's no reason for a kid to come out of their room," Branen said.

Sadly, she points out, they don't emerge as often as they used to, not even to eat dinner or play outside.

The demise of the nightly family dinner is a factor in obesity. Research has shown that ritual, shared, nightly meals decrease children's likelihood of smoking, drinking and drug abuse, among other vices, and positively impact many aspects of their social, personal and academic success.

Bringing families back to the table is a challenge. Reversing the trend toward inactivity is also challenging.

"Many children today can't play outside," Branen said. "They don't know what to do once they're out there. With videos games, they've become used to a story line being made up by someone else; they become fairly passive in terms of their entertainment. But children need active play. It is essential for developing motor skills and for cognitive development."

Branen currently is working with University of Idaho Professor Janice Fletcher, whose expertise is child development and feeding young children, and Susan L. Johnson, a researcher at the University of Colorado Denver, to develop a website for training childcare professionals on best feeding practices for young children.

Health organizations such as the American Academy of Pediatrics recommend at least one hour of vigorous play per day for young children, but young children don't naturally log that 60 minutes all at once.

"Young children are vigorously active for 10 or 15 minutes at time, then they stop to rest for a moment. During this rest, they often make a plan, or clarify some point in their story," said Branen. "Then they're vigorously active again, to the point where no adult can keep up with them. They have a real ebb and flow of activity that's very natural to early childhood."

On one level, obesity seems to be symptomatic of a changing definition of childhood: in the new millennium children are sitting down, in front of screen generally, and being quiet, just as parents have been requesting of them for decades. But the activities they are missing, from raucous, creative play to quiet family dinners, may well be the key ingredients for healthy childhood and adulthood.

"It's getting really kind of frightening," said Branen.

For more information on the Institute of Medicine or the Committee on Obesity Prevention Polices for Young Children, visit www.iom.edu.

Donna Emert is with the University of Idaho Communications department.