Scientific review published in Advances in Nutrition concludes, “starting early isn’t an option, it’s essential.”

Today in the United States, some 18% of children are obese.  These children carry an increased risk of asthma, type 2 diabetes, and orthopedic disorders.  Studies have also found a link between childhood obesity and poor academic performance.

The roots of childhood obesity can begin in utero.  Maternal obesity and excessive weight gain during pregnancy, for example, both correlate with a higher risk of childhood obesity.  Moreover, other determinants of childhood obesity, such as rapid weight gain during infancy, are well established before age five.

Obese children are more likely to become obese adults.  As obese adults, they will have a higher risk of many of the major causes of adult mortality, including coronary artery disease, hypertension, stroke, chronic kidney and liver disease as well as many types of cancer.  Collectively, the direct health care costs related to childhood and adult obesity are estimated to be more than $275 billion dollars annually.

Current guidelines recommend initiating screening for childhood obesity between ages six and twelve.  However, according to the authors of “Childhood Obesity Requires New Strategies for Prevention,” a Perspective published in Advances in Nutrition, the international review journal of the American Society for Nutrition, “this may miss an important window during which obesity may be developing in many younger children.”  Instead, the authors argue that childhood obesity prevention must start early, beginning with the implementation of strategies to achieve healthy maternal weight prior to pregnancy.

The authors then advocate for a broad range of infant and early-childhood interventions to reduce childhood obesity risk, including:

  • Improving the rate of exclusive breastfeeding for the first 6 months of life, which could reduce childhood obesity up to 30%.
  • Establishing early home health interventions and frequent weight and feeding monitoring for newborns identified as high risk for obesity.
  • Imposing taxes on sugar-sweetened beverages, which studies have shown reduces the consumption of added sugars in children’s diets.
  • Reducing obesity among adolescent and young adult women, leading to an estimated 10 to 22% reduction in childhood obesity, with ongoing effects for subsequent generations.
  • Investing in nutritional support for populations at highest risk for childhood obesity, including low-income families.
  • Increasing research, government, and industry efforts to reduce the public’s exposure to environmental obesogens, chemicals that alter the body’s ability to control weight gain.

Obesity is a chronic disease associated with a shortened life expectancy.  Because the determinants of obesity in childhood are well established before the age of five, this Perspective makes the case that “new policies directed at reducing obesity at the earliest stages…could alter the trajectory of childhood and adult obesity and improve population health, longevity, and quality of life throughout the life course.”  The authors conclude, “starting early isn’t an option, it’s essential.”

References Barbara J Deal, Mark D Huffman, Helen Binns, Neil J Stone, Perspective: Childhood Obesity Requires New Strategies for Prevention, Advances in Nutrition, DOI:

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