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Local and national factors contributing to falling obesity rates in young children

Childhood Obesity 3Q

Research shows that young children who are obese are five times as likely to be obese as adults and suffer from a variety of health issues. Deborah Dumphy, a family nurse practitioner specializing in pediatrics, international-board certified lactation consultant, and lecturer in the University of North Georgia's Family Nurse Practitioner program, shares how health professionals are helping decrease childhood obesity.

Federal health authorities recently reported a 43 percent decrease in the obesity rate among children ages 2 to 5 in the past decade. What contributed to this decrease?

Local and national initiatives deserve tremendous credit for helping to recognize the epidemic and beginning a change in direction. One local example is the Children's Healthcare of Atlanta's "Strong 4 Life" campaign, and a national example is the "Let's Move" initiative. New regulations are also a likely contributor.

In addition, these children are the infants from a few years ago who represent higher breastfeeding rates over the last decade. The risk reduction for obesity with breastfeeding is well-supported through research. At UNG we are also educating our future health care providers in addressing obesity. Nutrition, exercise and obesity are key concepts in the Associate of Science in Nursing, Bachelor of Science in Nursing and family nurse practitioner programs at UNG, and is prevalent in course content, clinical experiences and community service-learning projects.

How do primary caregivers, such as family nurse practitioners and physicians, try to address the obesity epidemic with parents and their children?

We try to address this epidemic at the family level. Obviously, preschoolers are not in a position of responsibility for the food choices found in their kitchen pantry and refrigerator, nor do they navigate the car through the fast food drive-thru. However, involving the child in age-appropriate health promotion education, including the discussion of healthy eating and adequate exercise, is important. Asking the child to list their favorite healthy snacks or meal choices and what activities they like to do for fun are great icebreakers with our older preschoolers.

It is also particularly important to educate the parents and remind them that they are the child's primary role model for healthy eating and exercise. I routinely have open discussions with families to determine which activities would work well to keep the whole family active — for example, daily walks or bike rides. The Strong 4 Life program includes these concepts and is used in my clinical practice site, Dawson Pediatrics.

In following the National Institute for Children's Healthcare Quality (2007) recommendations, every wellness visit starting at 2 years old should include obtaining the child's BMI (body mass index) and assessing for obesity. When an assessment indicates a child has a BMI of 85 percent or more, we begin more-focused interventions including meeting with a nutritionist and performing lab work. It is also important to commend those families "caught doing it right." Praising good behaviors does not just apply to our children — we need to support our families with praise and encouragement.

How might this trend affect the obesity rates of other groups?

If we continue to the use a family-centered approach to address obesity, the hope is we will see a decrease in rates of other groups, as well. As with any data, we have to be cautious in the interpretation, including national trends. I am a little hesitant to gregariously celebrate the reported national results just yet, as we still have a lot of work to do here in Georgia!

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