What does the evidence say about preventing obesity in young children?

The Australian Parliamentary Library produce reports on current issues to keep parliamentarians informed. Their latest report Obesity prevention in young children:what does the evidence say? provides a good summary of the prevalence, trends and challenges in combatting obesity in young children (1).

The report notes the rising cost of obesity, currently estimated to be $8.3 billion, and the need to prevent our present population of overweight young children becoming overweight adults. The 2007 Australian National Childrens Nutrition and Physical Activity Survey puts the prevalence of overweight and obesity in 2-3 year old boys at 17% and 4% respectively, and for girls at 14% and 4%. For boys aged 4-8 years, 13% are overweight and 5% obese and for girls 15% are overweight and 6% obese. Compared to 1995, there has been an increase in overweight and obesity in 2-3 year old boys, and a decrease in 2-3 year old girls of around 2.0%. In 4-8 year olds, except for a small decrease in overweight in girls, the general trend is an increase in both overweight and obesity.

There appears to be no consensus as to what age a child's weight predicts adult weight and therefore when prevention should begin. Some say for children under 3 years the parents weight is the best predictor of adult weight, while others say children who are overweight at 2 years are more likely to be overweight at 20 years. A systematic review conducted in 2005 concluded children between the ages of 3 months to 2 years who gained weight rapidly, were obese or at the high end of BMI were more likely to become overweight adults.

Some of the challenges faced in preventing and treating overweight in young children are :- 1. Parents not wanting their child to be labelled overweight/obese 2. Parents do not see their child as overweight/obese 3. Concern about focus on body image and its possible adverse effects on eating 4. Use of BMI as a measure of obesity.

There is little evidence on the effectiveness of obesity prevention programs in young children. Managing overweight/obesity through GP health checks has been shown to be costly with little improvement in a child's weight. As parental food and eating habits influence a child's food preferences, parent focussed education programs appear to be the best preventative strategy.

Reference:

1. Parliament of Australia. Parliamentary Library. Obesity prevention in young children:what does the evidence say? 1 May 2009 http://www.aph.gov.au/Library/pubs/bn/2008-09/ObesityChildren.htm