Everyone knows that obesity has become a national health problem. A recent report from the Robert Wood Johnson Foundation found that the obesity rate for 10-17 year olds in the U.S. was 15.8% in 2016-17.1 There is a great deal of variation among youth according to race/ethnicity and geography. African-American youth had an obesity rate of 22.5%, while Hispanic youth had a rate of 20.6% white youth 12.5% and Asian youth 6.4%. Likewise, Mississippi had the nation’s highest obesity rate for youth at 26.1%, with Utah having the lowest at 8.7%. That means that almost one in every four African-American children or teens is obese, and more than one in four youths in Mississippi are obese.
Why It Matters
It is important to realize that physicians are concerned about obesity not because of its cosmetic problems, but because it is a serious health issue. Anyone who is overweight is at greater risk of developing high blood pressure, type 2 diabetes, heart disease, asthma, several types of cancers, and other conditions. Many of these illnesses not only impact health, but can result in premature death.1 Obese children often become obese adults, so it is imperative that you do what you can to help prevent obesity in your child, both for her health now and in the future.
What You Can Do
Treatment for obesity at any age is difficult, which is why there is a emphasis on prevention. And behaviors and attitudes about food and health often begin at a very early age, so it’s never too early to start thinking about obesity prevention.
Our recommendations will be on what you can do in the first year of life, or even before then. Obviously, there are many steps to take later in your child’s life that will be important, too, but we will focus on the prenatal and infant periods.
- Many studies have linked gestational diabetes to obesity later in life. While gestational diabetes is not something that you usually can prevent, if you do have it, make sure you do everything to keep it well controlled. By combining diet, exercise, and medicine, pregnant women with diabetes can reduce the chance that their child will be macrosomic, or overly large.
- Parental weight has a tremendous effect on the child’s weight. Children of two obese parents have an 80% chance of being overweight, and this risk falls to 40% if only one parent is obese. And only 7% of children born to lean parents will develop childhood obesity.2 Obviously, genetics play a role in those outcomes, but if you or your spouse are overweight, do what you can to get to a healthy weight and that may increase your child’s chances of staying at a healthy weight, too.
- After the baby is born, another healthy step to take is to breastfeed your infant. You probably know that breastfeeding is best for the baby and for you for lots of reasons, but one of the most important is that it helps to decrease the risk of childhood obesity when compared to bottle feeding. And the longer you breastfeed, the lower the risk of obesity later in life.2 Exclusive breastfeeding for the first six months and then maintaining breastfeeding for the first year is recommended.3
- Feed your infant on demand, not on a schedule. This helps your child learn to eat when she is hungry, not to eat just because it is time to eat.3
- If you feed from a bottle (either pumped breast milk or formula), use smaller bottles, as larger bottles have been shown to increase feeding volume and are related to excess weight gain in infancy.3 The point isn’t to restrict feedings, but smaller bottles may allow you to better read your infant’s cues. Sometimes babies keep feeding simply because the milk is there, not because they are necessarily hungry.
- Delaying solid foods until 4 to 6 months has also been shown to decrease the risk of childhood obesity.3
- Avoiding juice in the first year of life is also linked to decreased obesity.3
- Once your child is on solid foods, controlling portions is key. Larger portions at meals and snack times has been associated with a greater risk of obesity. Many commercially packaged snacks are in sizes that are 2.5 times the adequate portion size for children.2
- Modeling the behaviors and attitudes to food that you want your child to have is also important. If the whole family, especially the parents, eat healthy, limit portions, don’t eat in front of the TV, and exercise regularly (especially as a family), these behaviors will seem second nature to the children.2,3
- Discuss with your pediatrician your child’s weight at each visit. Ask the doctor specifically if the weight is healthy. Parents are often not told that their child’s weight is unhealthy, but if they are aware of this, they will work at getting the weight under control.2,3 Don’t let your (often older) relatives convince you that your child needs to “eat more” if the doctor says her weight is fine: there is often societal and familial pressure to overfeed children, as many still believe “a fat baby is a healthy baby.”
- Robert Wood Johnson Foundation. National and state by state obesity rates, youth ages 10-17.
- Sothern MS. Obesity prevention in children: physical activity and nutrition. Nutrition. 2004 Jul-Aug;20(7-8):704-708.
- Brown CL, Perrin EM. Obesity prevention and treatment in primary care. Acad Pediatr. 2018 Sep-Oct;18(7):736-745.