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• W4241214877 abstract "The statistics are grimly familiar. According to the latest National Health and Nutrition Examination Survey, every other child in the USA now has a body-mass index (BMI) at or above the 85th centile on age-specific national growth charts for ideal weight gain. And a nationwide survey by the Kaiser Family Foundation published last month revealed that children aged 8–18 years devote on average 7·5 h per day to “entertainment media” such as television, music, computers, and video games. Now, US First Lady Michelle Obama has launched an ambitious initiative to eliminate childhood obesity within a generation.Data published in the New England Journal of Medicine last week provide clear proof that Obama's campaign has not come a moment too soon. In an impressive longitudinal study, almost 5000 Native American individuals were followed up for a mean of 24 years from childhood to adulthood to assess the effect of cardiovascular risk factors on premature death. The results showed that children whose BMIs were in the top quartile at a mean age of 11 years were more than twice as likely to die before the age of 55 years as those whose BMIs were in the lowest quartile. Although the population is not nationally representative, the researchers suggest that the Native American community is a bellwether for the country as a whole in terms of obesity.Obama's initiative, dubbed Let's Move, is a multifaceted intervention that tackles four drivers of childhood obesity: lack of parental knowledge about healthy food choices, poor standards of nutrition in schools, low levels of children's physical activity, and restricted access to healthy food shops in low-income areas known as “food deserts”. Fronted by an organised website equipped with everything from food pyramids to template shopping lists, the programme contains plenty of information for parents, schools, and communities. With the right motivation, and access to the internet, any parent should be able to take the scheme's advice to “make healthy choices” for their families.But will that motivation rise above the lure of power branding, cheap junk food, and the continued availability of vending machines in schools? The Obama administration must surely make legislative changes beyond simply demanding better nutritional information on food packaging. Childhood obesity is by no means unique to America, and one positive step that has been taken in countries such as Sweden, the UK, and South Korea is to ban junk food advertising during children's television programmes. Taxation could be increased on sugary drinks and other unhealthy processed food, making it less appealing financially. And junk-food vending machines in schools should be banned.Additionally, more must be done to target the crucial window of opportunity in which children's food preferences are set. The period between 6 months and 2 years of age is an absolutely vital developmental stage during which the types of food parents choose for their children can programme what they eat for the rest of their childhood lives, and perhaps longer. Research published in Clinical Pediatrics last week suggested that this crucial time could even be the “tipping point” of obesity itself. The small retrospective study of US children who had been classified as overweight or obese (BMI at or above 85th centile) before the age of 10 years showed that the median age of onset was 22 months.So of course schools should ensure that they provide nutritious food to the children in their care, but—as the chef Jamie Oliver found some years ago in his quest to improve school meals in the UK—by that stage the damage has often already been done. Young children will simply not eat what they are unfamiliar with, and pressure to do so from teachers can be distressing and ultimately counterproductive. The same attention to food standards must be applied to day nurseries, preschools, and kindergartens as a matter of priority.For parents, choosing the right food for a young child can be very difficult: cost, convenience, availability, familiarity, comfort, reward, and peer pressure all compete with the inherent desire to do what is best for the child's health. There is thus an urgent need for more advice and support for parents of children between 6 months and 2 years of age. The face-to-face nutritional advice offered by health-care professionals to pregnant women and new mothers must be extended through the crucial stages of weaning and beyond, and must be coupled with schemes to make healthier food more affordable and accessible. For the Kaiser Family Foundation survey on media use in US children see http://www.kff.org/entmedia/upload/8010.pdf The statistics are grimly familiar. According to the latest National Health and Nutrition Examination Survey, every other child in the USA now has a body-mass index (BMI) at or above the 85th centile on age-specific national growth charts for ideal weight gain. And a nationwide survey by the Kaiser Family Foundation published last month revealed that children aged 8–18 years devote on average 7·5 h per day to “entertainment media” such as television, music, computers, and video games. Now, US First Lady Michelle Obama has launched an ambitious initiative to eliminate childhood obesity within a generation. Data published in the New England Journal of Medicine last week provide clear proof that Obama's campaign has not come a moment too soon. In an impressive longitudinal study, almost 5000 Native American individuals were followed up for a mean of 24 years from childhood to adulthood to assess the effect of cardiovascular risk factors on premature death. The results showed that children whose BMIs were in the top quartile at a mean age of 11 years were more than twice as likely to die before the age of 55 years as those whose BMIs were in the lowest quartile. Although the population is not nationally representative, the researchers suggest that the Native American community is a bellwether for the country as a whole in terms of obesity. Obama's initiative, dubbed Let's Move, is a multifaceted intervention that tackles four drivers of childhood obesity: lack of parental knowledge about healthy food choices, poor standards of nutrition in schools, low levels of children's physical activity, and restricted access to healthy food shops in low-income areas known as “food deserts”. Fronted by an organised website equipped with everything from food pyramids to template shopping lists, the programme contains plenty of information for parents, schools, and communities. With the right motivation, and access to the internet, any parent should be able to take the scheme's advice to “make healthy choices” for their families. But will that motivation rise above the lure of power branding, cheap junk food, and the continued availability of vending machines in schools? The Obama administration must surely make legislative changes beyond simply demanding better nutritional information on food packaging. Childhood obesity is by no means unique to America, and one positive step that has been taken in countries such as Sweden, the UK, and South Korea is to ban junk food advertising during children's television programmes. Taxation could be increased on sugary drinks and other unhealthy processed food, making it less appealing financially. And junk-food vending machines in schools should be banned. Additionally, more must be done to target the crucial window of opportunity in which children's food preferences are set. The period between 6 months and 2 years of age is an absolutely vital developmental stage during which the types of food parents choose for their children can programme what they eat for the rest of their childhood lives, and perhaps longer. Research published in Clinical Pediatrics last week suggested that this crucial time could even be the “tipping point” of obesity itself. The small retrospective study of US children who had been classified as overweight or obese (BMI at or above 85th centile) before the age of 10 years showed that the median age of onset was 22 months. So of course schools should ensure that they provide nutritious food to the children in their care, but—as the chef Jamie Oliver found some years ago in his quest to improve school meals in the UK—by that stage the damage has often already been done. Young children will simply not eat what they are unfamiliar with, and pressure to do so from teachers can be distressing and ultimately counterproductive. The same attention to food standards must be applied to day nurseries, preschools, and kindergartens as a matter of priority. For parents, choosing the right food for a young child can be very difficult: cost, convenience, availability, familiarity, comfort, reward, and peer pressure all compete with the inherent desire to do what is best for the child's health. There is thus an urgent need for more advice and support for parents of children between 6 months and 2 years of age. The face-to-face nutritional advice offered by health-care professionals to pregnant women and new mothers must be extended through the crucial stages of weaning and beyond, and must be coupled with schemes to make healthier food more affordable and accessible. For the Kaiser Family Foundation survey on media use in US children see http://www.kff.org/entmedia/upload/8010.pdf For the Kaiser Family Foundation survey on media use in US children see http://www.kff.org/entmedia/upload/8010.pdf For the Kaiser Family Foundation survey on media use in US children see http://www.kff.org/entmedia/upload/8010.pdf" @default.
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• W4241214877 title "Childhood obesity: affecting choices" @default.
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