The Earlier, the Better

In the United States, 1 in 5 preschool children are overweight or obese [1]. Among low-income children, these rates climb even higher [2]. Obesity at such a young age has dire consequences, as obese children are more likely to suffer from obesity and obesity-related co-morbidities later in life [2]. In fact, obese children at this age can already show signs of poor health. Inflammatory biomarkers appear in obese children as young as age 3 and increase the risk for heart disease in adulthood [2]. Because health in early life has such as effect on health later on, it is important obesity prevention starts as early as possible. One of the most promising settings for early childhood obesity prevention is in preschool and childcare facilities.

Among children in the U.S., 61% of those less than 6 years old are in some form on non-parental childcare [2]. Most preschool children with employed parents can spend an average of 40 hours per week in these settings [1]. With so much time spent in one place, childcare facilities have the potential to be an effective setting in which to target early childhood and establish healthy habits at a young age. Despite this, evidence shows that most states do not have strong regulations regarding healthy eating and physical activity in childcare settings [1]. Thus, these settings should develop strategies to improve nutrition offered to children, encourage and increase active playtime, and promote healthy behaviors to children and their families.

One promising approach to addressing obesity in early childcare settings was through the Active Early project provided by the Wisconsin Early Childhood Obesity Prevention Initiative (WECOPI). Active Early sought to increase physical activity among 2- to 5- year olds by promoting collaborative, evidence-based approaches statewide [3]. WECOPI piloted interventions at 20 early childhood education sites that worked to create indoor and outdoor environments that encouraged active play, policies that promoted healthy role modeling, and active class time with teacher-led activities. The intervention demonstrated a three-fold increase in physical activity among these children and was easy to implement in almost all of the sites [3]. By developing a systems perspective and creating partnerships with others who also interact with young children, WECOPI was able to show that incorporating 120 minutes a day of physical activity into early childhood settings is feasible and effective. In order to create sustainable change in early childhood obesity, future steps should be taken to address environmental factors in other settings. By collaborating with diverse partners across the state, multi-level change can be accomplished, and Wisconsin can be one step closer to overcoming childhood obesity.

  1. Larson N, Ward DS, Neelon SB, et al. What Role Can Child-Care Settings Play in Obesity Prevention? A Review of the Evidence and Call for Research Efforts. J Am Diet Assoc. 2011;111:1343–1362.
  2. Nader PR, Huang TTK, Gahagan S, et al. Next Steps in Obesity Prevention: Altering Early Life Systems To Support Healthy Parents, Infants, and Toddlers. Childhood Obesity. 2012; 8,3:195–204.
  3. Podcast interview with Molle Polzin (Wisconsin Department of Public Instruction) and Jill Hoiting (Supporting Families Together Association)