Family Health Guide

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Childhood Obesity: Prevention

There are steps you can take to help an overweight child achieve a healthy weight. Many of these approaches will also benefit normal-weight children:

Begin in infancy
Breastfeed if you can. Research suggests breastfeeding may lead to a reduced risk of the child becoming overweight later. Not only do compounds in breast milk help regulate appetite and body fat, but breastfed babies may also be more likely to take in only as much as they need.

If you bottle-feed, resist the urge to encourage your baby to always finish that last ounce  -- whether it's formula or expressed breast milk  -- if he's signaled he's full. And don’t automatically pop a bottle in his mouth every time he cries. Your child may just want a clean diaper, or a nap, or just your attention.

When your baby moves on to solid food, try to keep in mind that solids are mostly for practice at this stage. The bulk of your baby’s nutrition will still come from breast milk or formula until her first birthday. There’s no need to push your baby to finish off jar after jar of food at every sitting; continue to follow her cues that she’s had enough.

Some new moms worry their chubby baby may be at risk for obesity later. While some studies have found a link between heavy babies and childhood obesity, moms should not count or cut calories in the first year, and should just concentrate on helping their babies to grow.

Focus on healthful foods
From the beginning, focus on building a solid nutritional base and a palate of healthy foods. Encourage kids to eat five fruits and vegetable servings per day, focusing on whole grains, including lean meats and low-fat or fat-free dairy products. High-calorie treats should be avoided, especially in very young kids. Avoid soda and limit your kid’s juice intake, as both are essentially empty calories and may make them too full to want to eat healthier foods. A better choice would be an actual piece of fruit, which contains satiating fiber and cancer-fighting antioxidants.  Talk early and often with your kids about why healthy food is good for your body, and don’t use food as a reward or punishment.

Try these 10 superfoods for kids

Watch portion size
Many parents are unclear about exactly how big a serving size is. Good news: you don’t need to buy a scale -- simply use your child’s hand as a guide. A kid-size portion of meat is about the size of his palm. For carbs, fruits and veggies, the serving size is equal to the size of his fist. A snack should be about a handful, and a serving of cheese is about the size of his thumb.

Cook meals at home
Cooking can be a powerful tool for weight loss and healthy weight maintenance. It allows you to choose whole ingredients and control portion sizes. Get your kids involved -- they’re more likely to eat healthy foods if they’ve had a hand in creating them. Page through a cooking magazine together or sort through recipes online and ask them which dishes look interesting, then go grocery shopping together and pick out nutritious, lower-fat and calorie ingredients, like part-skim mozzarella instead of full-fat for veggie lasagna, or applesauce instead of oil for brownies. Pack school lunches together or plant a family garden -- try anything that involves them and allows them to make decisions in a fun way. Research has also shown preschoolers who sit down to regular family meals have a lower risk for obesity.

Forget the clean plate club
If your kid is pushing food around their plate, that’s a sign they might be full. Dealing with a picky eater, who just doesn’t do veggies? Although it’s fine to insist that they try just one bite of everything, don’t press them to gag down foods they truly don’t like, even in the name of healthy eating. One trick that really works: put out veggies first, when kids are hungriest and most likely to eat them.

Avoid focusing on cutting calories
Children need extra nutrients to fuel their growth. Rather than obsess over calorie cutting, focus on balancing diet with physical activity, managing portion sizes, and incorporating lots of high-nutrient foods that are naturally lower in calories, like fruits, vegetables and low-fat or nonfat dairy. The exception: If your child is clinically obese, the doctor may feel the need to prescribe a stricter calorie-controlled program.

Encourage physical activity 
Get your kids moving! This can start in infancy: Your baby needn’t be confined to the crib. Let her explore in a safe environment, which will aid in muscle development. Head outside with toddlers as often as possible instead of plunking down in front of the television. Most experts say that children under the age of two should have no screen time at all; human interaction and physical activity are preferred at this stage. However, we all know moms need an electronic babysitter now and then, so Parenting’s stance is not to beat yourself up if you must pop in a DVD to take a shower or wrestle up a family dinner. Just be judicious about how often you rely on it.

As they grow older, continue to monitor your children’s TV and computer time; kids over age two should be limited to two hours of TV/computer time per day and should be getting one hour or more of physical activity per day. Active children are more likely to become fit adults, so encourage them to join sports teams or play tag in the back yard. Physical activity not only burns calories but builds strong bones and muscles and helps children sleep well at night and stay alert during the day. One way to make physical activity seem more appealing is to identify activities your child truly enjoys: nature lovers can take family walks; kids who like to climb can be treated to a post-dinner trip to the neighborhood jungle gym.

Involve the entire family
Rather than single out one child, talk to the entire family about the importance of a healthy diet for everyone. This will help prevent the overweight child from feeling guilty, chastised or embarrassed. Always avoid making disparaging comments; an intense focus on your child's weight and eating behaviors can backfire, which can pave the way to an eating disorder where a child may either end up eating even more or drastically cutting back in an unhealthy way.

Be a role model
Set a good example by making it a point to incorporate healthy foods and exercise in your own lifestyle.

Schedule yearly well-child visits
Take your child to the doctor for annual well-child checkups so her height, weight and BMI can be tracked. Increases in your child's BMI or in his or her percentile rank over one year, especially if your child is older than age 4, may signal that your child is at risk of becoming overweight.

Many overweight children simply grow into their extra weight as they grow taller. Even if that’s not the case with your child, remember that what’s important is that you’ve noticed the problem and are taking steps to address it.