PRESCHOOL HEALTH PREVENTION NOT INTERVENTION     
By Michele Silence

Diet and exercise. Calories in vs. calories burned. The idea is to balance calories eaten with those expended to maintain a healthy weight and live an enjoyable life. Experts believe this simple mathematical equation is a first step in curbing obesity, diabetes, heart disease and a number of other diseases and conditions. The challenge of course is how to set up the process early on for children. How young can we start? Just what should we do?

Far too many individuals, including physical education teachers, believe that the time to seriously start teaching children about healthy eating and regular exercise is after Kindergarten. Contrary to popular belief, children need to learn healthy habits as early as possible. Once children have preset routines, attitudes and opinions it will take a great deal of effort to have any impact at all on them. Then the effort will be directed towards changing behavior instead of seamlessly integrating it into a child’s life – a much harder task. To effectively help children we’ve got to start thinking prevention, not intervention. And preventative measures can never start too early.

Developing healthy lifestyle habits begins the minute a child is born or perhaps even sooner. Research is now suggesting that the intrauterine environment is capable of setting up a child for diabetes, obesity, heart disease and even some forms of cancer (Journal of Nutrition, 2001; Monatsschrift Kinderheilkunde, Feb. 2001). What a mother eats, or doesn’t eat, while pregnant has a huge impact on the developing fetus. One substantiated thought is that an undernourished fetus must make physiological and neural adaptations while in the womb to survive. It’s those adaptations that lead to a propensity towards a multitude of adult diseases resulting in a shorter lifespan.

Look at the average adult diet. Many adults don’t eat anywhere near enough fruits or vegetables, and consume far too much sugar, fat and salt. What is the chance that a typical pregnant mother is eating a nutritious diet for both her and her developing baby? She may be taking all the required vitamins, but what foods are actually going in her mouth and in what quantities? Eating for two may give women permission to eat more than they know they really should. This notion has done more harm than good since prenatal overeating has been associated with fatter babies (Am J Obstet Gynecol, 2003). And fatter babies are more likely to grow up to be fatter adults.

Once a child is born, the challenge to balance energy intake is relatively simple. Newborn babies have a high metabolism and receive sound nutrition from either formula or breast milk. One advantage of breast feeding is that breast fed babies are said to enjoy a very high degree of protection from becoming obese (American Journal of Clinical Nutrition, 1993).

As the time nears for the introduction of solid food, many underestimate how important the next year or two is in relationship to a child’s future eating patterns. Mothers in particular seem to influence children dramatically with their own food preferences (Journal of the American Dietetic Association, 2002). It’s known that children’s food preferences are already formed by the time they reach age two. What foods they’ve been exposed to at that time will dictate what they want to eat later.

Toddlers should be eating a large variety of foods with different tastes, colors and textures. But again, looking at the average adult diet, it’s easy to see why more and more tiny children are seen chewing on French fries before they can talk. Fast food restaurants advertise this as “cute” and love seeing parents give young children their artery-clogging products. For educators and parents the sight of a preschooler eating fast food should signal a huge red warning flag. If this is the beginning, can we really expect children to want and ask for carrot sticks later? What chance does a child have who goes from baby food to fast food. Especially with daily food choices that include chicken nuggets, pepperoni pizza, cheeseburgers, milkshakes, quesadillas, hot dogs, and soda. Just look at the cereals routinely given to tiny kids for snacks. Shouldn’t children be nibbling and teething on whole grain foods instead of Trix and Lucky Charms?

Infants and toddlers also need to be touched, moved and played with. Early movement activities are the building blocks for enjoyable regular physical activity later. Studies have shown that activity levels in children decline with age and that the most active time in a child’s life is during the first 3 years (Medicine & Science in Sports & Exercise, Jan 2009). These are the years in which children are found moving and running around the most with adults telling them, ironically, to sit down, don’t run and be still. This is their first lesson in living a sedentary life.

Just as with a number of other crucial windows of time for specific brain development, there are critical periods for becoming proficient at lifelong sports skills. The earlier children are exposed to catching, tossing, throwing, kicking, rolling, bouncing, balancing and striking, the more comfortable they’ll be using those skills later in life. Would you get excited about playing basketball as a teen or adult if you never learned how to bounce or dribble a ball? I think not. You’d probably rather watch it on television or play a basketball video game.

It would be nice if we could just wave a magic wand over a child’s head and “pouf,” they instantly stay active and want only the healthiest foods. However, the truth is we can’t expect young children to value physical exercise when they don’t see the adults around them getting any (see chart below). Whether its family, teachers or other care givers, children need to be provided with role models for movement. Families need to walk more, bike, recreate and try a variety of different sports together. You’d be surprised at how many times adults have asked me if I can help their young child lose weight, but refuse to make any changes in their own diet or activity patterns. A teacher who talks about healthy lifestyles out of one side of their mouth, while ordering pizza for a class celebration out of the other side, only compounds the confusion. We all need to walk the talk.

We can’t wait for a specific age or time in life to start instilling sound nutrition and healthy habits. Children need to build regular exercise and good dietary choices into their psyches now. These habits need to become as everyday of a routine as any of the other self care habits we teach them, so much so that it doesn’t take a second thought, it’s as automatic as buckling a seat belt, washing their hair, or brushing their teeth. No adult consciously thinks about any of those habits because they’ve been ingrained from the start. It can mean the difference between a long, enjoyable, high quality life and one that is plagued by chronic conditions, countless medications, sky high medical costs, and lifelong suffering.

By the time children are old enough to ask for help it’s too late – they’ve already passed along their unhealthy habits to another generation and are paying the physical and emotional price. The solution is to start now. That means with each one of us, the ball is in our hands. We won’t be able to pass the ball to our next generation for a number of years, until their hands are large enough to hold it. If we drop the ball now, they’re the ones who will lose. That’s evident with the current data which suggests parents are going to start outliving their children if children’s lifestyle habits don’t change soon.

Look at the youngest children you know and remember, it’s up to you to help them develop lifelong health starting now. It’s the only way to break the obesity cycle and reduce the risk of all the other serious adult diseases now seen in children. We have the ability to give our children the best gift ever – a fit body and a healthier tomorrow. A priceless gift no one can ever take from them.

Parental factors that affect food intake and physical activity among young children.

References:
Barker, DJP. Fetal and infant origins of adult disease. Monatsschrift Kinderheilkunde. Volume 149, Number 13 / June, 2001.
Dewey, KG et al. Breast-fed infants are leaner than formula-fed infants at 1 y of age: the DARLING study. American Journal of Clinical Nutrition, Vol 57, 140-145. 1993.
Ekbom, A. et al. Intrauterine environment and breast cancer risk in women: a population- based study. Journal of Nutrition. 131:874S-880S, 2001.
Martorell, R. et al. Early Nutrition and Later Adiposity. Am J Obstet Gynecol 189:1698-704, 2003.
Skinner, JD et al. Children's Food Preferences A Longitudinal Analysis. Journal of the American Dietetic Association, Volume 102, Issue 11, Pages 1638-1647, 2002.
Taylor, R.W. et al. Longitudinal Study of Physical Activity and Inactivity in Preschoolers: The FLAME Study. Medicine & Science in Sports & Exercise. 41(1):96-102, January 2009.
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Michele Silence, MA, is a 23-year fitness professional, trainer, educator, writer and CEC provider. She is the president of Aerobic Fitness Consultants and the creator of KID-FIT, physical education classes for preschoolers. KID-FIT has been piloted nationwide, featured in the LA Times, on numerous television news shows, and is listed by Action for Healthy Kids as a program that works.

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