Features
Childhood obesity: The caregiver’s role
continued
Preparing and serving healthy foods
Those who prepare and serve meals and snacks to young children need to examine
how their practices may contribute to obesity. In a recent nutrition education
workshop, a cook at a child care center said she didn’t fry any foods
that were served to the children. When participants were asked later to list
the favorite foods served to children in their centers, this same individual
volunteered “steak fingers.” When the workshop leader pointed
out this was a fried food, she replied, “I didn’t fry the meat.
I just warmed it in the oven.” She didn’t realize that the prepared
steak fingers had been previously fried. Serving a prepared food may be faster
and easier, but it may also add calories to the meal.
 Serving prepared foods is increasing, despite their higher cost, because child
care staff do not have the time, energy, or expertise to fully prepare foods
themselves. Extra calories contribute to potential obesity, and serving unhealthy
food leads to lifelong preferences and habits.
Portion size is an important factor in obesity (Young, 2002). Americans now “super-size” everything
and expect to be served mounds of food at every meal. Caregivers need to help
children learn to regulate their food intake and recognize the sensation of
feeling full. Serving recommended portion sizes to young children is essential.
Start with an appropriate amount and give seconds only if the child wants more.
Many caregivers report that children are now requesting third, fourth, and
fifth servings of specific foods. An appropriate rule is to provide only one
additional serving of a specific food, unless the child has a diet restriction
and cannot eat other foods that are served. When children request a second
helping, don’t make them eat all other foods on their plates.
Encourage children to eat slowly, because the fullness sensation develops over
time. Involving children in conversation about foods and eating preferences
during snacks and mealtime helps to slow the intake rate and also provides
an opportunity to discuss nutrition and foods on a daily basis. By allowing
children time to acquire the fullness sensation, you may reduce requests for
additional servings.
Serve meals and snacks at specific times and remove food when mealtime is over.
Some children are naturally slow eaters and may need a few extra minutes to
finish the meal. Eating should not become a stand-off between caregiver and
child. If a child chooses not to eat, then remove the food and ask the child
to move on to the next activity. Explain that the child will have another chance
to eat at the next snack or mealtime.
Eating is a social behavior that is strongly influenced by the culture and
traditions of society. The eating behavior of other children can serve as a
role model and a social pressure for influencing a child’s food preferences.
Seating a child who refuses to eat corn with other children who love corn will
likely increase the child’s willingness to eat corn.
Model what you teach. Don’t have coffee, a donut, or a can of soda in
the room if you expect children to eat healthy foods at regular times.
Encouraging physical activity
Many caregivers might be surprised to learn that experts recommend an increase
in physical activity for preschool children. Most of us spend much of the
day trying to calm children and lessen their activity.
However, young children need to develop and practice motor skills. By incorporating
active play and activities in the daily routine, we encourage an active childhood
and lay the foundation for an active and productive adulthood. Research (Gabbard,
1998) indicates that the “window of opportunity” for acquiring
basic motor movements is from the prenatal period to age 5. The development
period for fine motor skills extends from infancy to around 9 years of age.
Childhood fitness and movement activity needs to be fun and appropriate for
the age of the child. Remember that play is children’s work and their
way of exploring, learning, and exercising.
Children need early opportunities to climb, walk, run, kick, throw, and jump.
They need to develop eye-hand coordination by participating in activities such
as working puzzles, building blocks, and stringing beads. Development of eye-foot
coordination depends on activities such as kicking large balls. Helping children
acquire and practice these skills provides the foundation for physical abilities
later in life.
What about children who are inactive and just sit on the playground? Consider
a routine of rotating children through various areas such as swings, bikes,
and sandbox to encourage more active participation. Encourage children to select
or assign them to begin in a different area of the playground for the first
few minutes each day before choosing their favorite play area. This encourages
development of different types of motor play and helps children to develop
proficiency and skills in many areas.
Working with parents
It’s important to educate families about nutrition and preventing obesity.
Here are suggestions for working with families and their children:
 Encourage parents to be involved in all areas of their child’s life.
Children need to know that parents love and care for them regardless of their
physical qualities. Part of parents’ love and care is encouraging a healthy
diet and activities suitable for preschool children.
Some parents may need help in learning what is appropriate for children at
a certain age. You can provide information about your activities at the center
and ways to follow up at home. Send home suggested activities for outside active
play and for healthful snacks that children can help prepare.
Nutrition information that reinforces food and cooking topics covered in the
child’s classroom is especially helpful. For example, “Chef Combo” nutrition
materials distributed by the National Dairy Council (1998) include leaflets
that you can copy and send home with parents.
Be sensitive to the cultural backgrounds of parents. In some cultures a large
child is considered healthy. Obese parents may feel an overweight child is
not a problem. Be sensitive to such issues and approach obesity from the standpoint
of long-term health and well-being. Emphasize the child’s inability to
participate in all activities and its effect on self-concept.
Recommend a healthy diet to parents. Help parents to see the importance of
healthy eating. Suggest healthy snacks children can eat on the way home at
the end of the day. Recommend apples, carrots, and graham crackers instead
of chips, fast foods and other high-fat foods that may seem more convenient
to a hurried parent trying to get home with hungry children.
Encourage parents to examine their own levels of activity and eating patterns
as well as their need to set a healthy example. It is hard to keep children
from eating while watching TV if the parents are having snacks. Parents may
be unaware of how many calories they consume as they watch television.
Dealing with an obese child
These suggestions are primarily directed at preventing obesity in young children.
What can you do about an obese child in the classroom?
Talk with parents in an effort to express concern and provide information.
Describe how obesity is hampering the child’s participation in activities
and how that behavior is different from that of other children in the classroom.
Discuss strategies for cutting back food consumption and for encouraging the
child to become more active. Although most obesity is not caused by health-related
problems, you might suggest that the parents contact their physician or public
health staff in dealing with the problem.
Obesity has become a serious concern in this country. Preventing it in early
childhood is much easier than trying to undo unhealthy eating habits and activity
patterns in adulthood.
References
Birch, L., “Research Example 1: The Role of Experience in Children’s
Food Acceptance Patterns,” Supplement to the Journal
of the American Dietetic Association, Vol. 87, No. 9, 1987, pp. S36-S40.
Birch, L.; L. McPhee; L. Steinberg; and S. Sullivan. “Conditioned Flavor
Preferences in Young Children,” Physiology and Behavior, Vol. 47, 1990.
Birch, L. “How Kids Choose Foods,” research presented at International
Conference of Gastronomy, Monterrey, Calif., March 11, 1994.
Chef
Combo’s Fantastic Adventures in Tasting and Nutrition, National
Dairy Council, Rosemont, Ill., 1998.
Gabbard, C. “Windows of Opportunity for Early Brain and Motor Development,” Journal
of Health, Physical Education, Recreation and Dance, Vol. 69, No. 8, 1998,
pp. 54-60.
Morgan, R., “Evaluation and Treatment of Childhood Obesity,” American
Family Physician, Feb. 15, 1999.
The
Surgeon General’s Call to Action to Prevent and Decrease Overweight
and Obesity—Fact Sheet. www.surgeongeneral.gov/topics/obesity/calltoaction/fact_consequences.html.
Swadener, S., “Nutrition Education for Preschool Age Children: A Review
of the Research,” www.nal.usda.gov/fnic/usda/preschoolne.html.
U. S. Department of Agriculture, Center for Nutrition Policy and Promotion,
1999.
U. S. Department of Health and Human Services, “Obesity Still on the
Rise, New Data Show,” www.cdc.gov/nchs/releases/02news/obesityonrise/html.
Young, L., “The Contribution of Expanding Portion Sizes to the U. S.
Obesity Epidemic,” American Journal of Public Health, Vol. 92, No. 2,
2002, pp. 246, 49.
About the author
Bernadette Haschke, PhD, is an associate professor in the Department of Family
and Consumer Sciences at Baylor University in Waco, Texas. She has served
as a teacher and director in early childhood programs. She is a trainer for
the Texas Career Development System for Early Care and Education and conducts
workshops on childhood obesity. |
