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Study: Obesity Prevention Should Focus on Day Care

Lax Regulation Means Many Kids Don’t Get Enough Healthy Foods or Exercise
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WebMD Health News
Reviewed by Laura J. Martin, MD

Aug. 26, 2011 -- Experts say the fight against childhood obesity should have a new focus: day care.

Studies show that about 82% of American children under age 6 are in child care outside the home while their parents work.

That means many meals are no longer eaten around the family table, but at day care, where parents may have little control over what toddlers are eating.

Kids in full-time day care can get two-thirds of their daily calories there, “so it’s really other adults who are driving the nutritional value of what children consume,” says study researcher Sara Benjamin Neelon, PhD. She's an assistant professor in the department of community and family medicine at Duke University Medical Center in Durham, N.C.

In a new study, published in the Journal of the American Dietetic Association, Benjamin Neelon and her colleagues reviewed 42 studies of obesity prevention related practices in day care.

They found that most states have minimal requirements for healthy eating and physical activity in child care that may differ from public health expert recommendations. Experts who were not involved in the research praised its scope and said that while it points to substantial problems, it also suggests that day care can be an important place to make lasting changes in a child’s life.

Starting Young

“In general, there’s been an increasing awareness that we have to start tackling obesity very early in a child’s life,” says Alice Ammerman, DrPH, a nutrition professor and director of the Center for Health Promotion and Disease Prevention at the University of North Carolina at Chapel Hill.

“I think things are moving in the right direction, but I think there’s a lot of potential for greater improvement,” particularly through day care, Ammerman says.

Day Care Menus

Day care centers that qualify for government financial assistance must meet guidelines that call for kids to get foods high in nutrients but low in fat, sugar, and salt.

But studies have shown that some day care centers fall short of meeting those standards.

For example, in Texas, research was done at nine child care centers to determine if meals served provide children with enough grains, fruit, vegetables and protein to meet 1/2 to 2/3 of the daily amount recommended by federal nutrition guidelines. Researchers found that less than half of 3-year-olds got enough grains, vegetables, or dairy to meet 1/2 the daily recommended amount. Two out of three children ages 4 and 5 only got enough dairy to meet half of the dairy recommendation, but fewer than half got the recommended amount for any other food group. What’s more, the meals kids ate at home did not fully replace missing nutrition during child care.

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