5-4-3-2-1 Go! campaign, 128
A
Access to affordable healthy foods, 6, 12-13, 23-24, 27-28, 85, 101-106, 159
Adiposity in children
defined, 157
predictors of, 44
prenatal factors, 50
sleep restriction and, 138
television advertising exposure and, 6, 122, 125
African Americans/blacks, 19, 87, 124
American Academy of Pediatrics (AAP), 10, 11, 35, 39, 73, 86, 87, 94, 97, 120, 124
American Dietetic Association, 10, 73
Americans with Disabilities Act, 9, 61, 67
Animal Trackers intervention, 65
Arizona, child care standards, 30
Avon Longitudinal Study of Parents and Children (ALSPAC), 45, 48
B
Baby-Friendly Hospital Initiative (BFHI), 11, 86, 88, 89, 90, 157
Behavioral mapping, 68-69
Bisphenol A, 153
Body mass index (BMI)
CDC gender-specific charts, 37, 39-42
defined, 157
monitoring, 8, 35-36, 37, 38, 39-42
overweight definition, 40-42, 160
phthalates in blood and, 154
rationale for monitoring, 42-44
sleep habits and, 137-138
WHO growth charts, 39
Bottle feeding, 90-92
Breastfeeding
AAP recommendations, 11
Baby-Friendly Hospital Initiative, 11, 86, 88, 89, 90, 157
barriers to, 87-88
bottle feeding breast milk, 90-92
prevalence, 87
promoting and supporting, 11, 86-88, 89, 90, 157
race/ethnicity and socioeconomic status and, 87, 88
rationale for recommendations, 87-90
state laws, 88-89
Surgeon General’s Call to Action to Support Breastfeeding, 87-88
Ten Steps to Successful Breastfeeding, 89, 91
worksite policies, 11, 28, 87, 88-89, 90
Built environment for physical activity, 5, 9, 23, 27, 61, 62-63, 65-70
C
Cadmium, 154
Calorie-dense, nutrient-poor foods, 27, 122, 138, 158
Carbamates, 153
Cardiovascular disease, 45, 48, 94
Centers for Disease Control and Prevention (CDC), 1, 14, 19, 43, 87, 125
BMI gender-specific charts, 37, 39-42
growth charts, 8, 35, 36, 38, 39, 42
screen time recommendations, 123
Task Force on Community Preventive Services, 123
VERB campaign, 127-128
Charge to committee, 17-18
Child and Adult Care Food Program (CACFP), 5-6, 11, 13, 30, 87, 93, 94, 95, 101, 103-105, 107
Child care settings (see also Standards for child care)
Breastfeeding Friendly, 11, 90, 91
crib, car seat, and high chair use, 70
decreasing sedentary behavior, 9-10, 70-72
healthy eating, 5-6, 11, 23, 93, 101, 103, 107
home-based vs. center-based, 122
in low-income neighborhoods, 27-28
physical activity, 5, 8-9, 29, 61, 65-66, 70
quality of, 72
screen time in, 13, 29-30, 72, 121, 122
staff development/training, 10, 67, 72-76, 107
strollers, swings, and bouncer seats/chairs, 70
Childcare Mealtime and Active Play Partnerships (ChildcareMAPP), 102
Children with disabilities, physical activity, 5, 9, 61, 67, 69-70, 74
Collaborative Perinatal Project, 47-48
Consumer Product Safety Commission, 68
D
DDT, 154
Delaware, child care standards, 30, 71, 74, 101
Diet of U.S. children (see also Breastfeeding; Eating behavior; Healthy eating; Infant formula)
added sugar, salt, and fat, 21, 85, 93, 94, 96-97
CACFP meal patterns, 93
calorie-dense, nutrient-poor foods, 27, 122, 138, 158
dairy products, 19, 37, 85, 91, 94, 96-97, 105, 159, 162
fruits and vegetables, 19, 21, 27, 85, 93, 94-96, 104, 105, 106, 126, 159
sugar-sweetened beverages, 19, 91, 96-97, 158, 162
whole grains, 37, 85, 94-95, 96, 105, 159
Dietary Guidelines for Americans (DGA), 6, 12, 60, 93, 94, 97, 98, 158
Dietary guidelines for children under 2 years, 6, 12, 97-98
Diethylstilbestrol, 153
E
Early Childhood Environment Rating Scale-Revised (ECERS-R), 72
Early Head Start, 11, 87, 90, 101, 160
Eating behavior (see also Diet of U.S. children; Healthy eating)
development of food preferences, 85-86, 93, 96, 97, 99, 119, 121, 122, 125, 128
marketing/advertising and, 119, 121, 122, 125, 128
rewards or bribes and, 99
self-regulation, 6, 12, 98, 99, 100, 101
Electronic medical records, 39
Emergency Food Assistance Program, 104
Endocrine-disrupting agents, 153-154
Environment and Policy Assessment and Observation instrument, 72
Environmental risk factors (see Eating behavior; Sedentary behavior; Sleep)
Ethnic/racial differences
physical activity, 69
screen time, 124
sleep duration and environment, 124, 135
Evaluation of policies (see also Research on obesity prevention), 7, 24-25
Evidence on obesity prevention, 24-25
F
Fair Labor Standards Act of 1938, 88
Family and Medical Leave Act, 89
Farmers’ Market Nutrition Program, 104
Federal Communications Commission, 11, 86
Federal Trade Commission, 14, 121, 125
Feeding cues, 12, 92, 98, 99, 100
First Steps for Mommy and Me, 142
Food and Drug Administration, 14, 125
Fresh Fruit and Vegetable Program, 104
Fruit juices, 97
G
Gender differences, 19
Gestational diabetes, 46, 49-51
Green Carts initiative, 105, 106
“Growing out of it,” 1, 19
Growth monitoring
BMI calculations, 8, 35-36, 37, 38, 39-42
CDC charts, 8, 35, 36, 38, 39, 42
CDC updated guidelines, 38-44
discussions with parents, 35, 37, 44
electronic medical records and, 39
goal, 35
by health care providers, 4, 5, 8, 35-44
misperceptions of excess weight, 1, 19, 37-38
parental weight status and, 8, 37, 42, 44
rate of weight gain, 8, 19, 37, 42, 43
rationale for recommendations, 38-44
training of health care providers, 35, 42
underdiagnosis of obesity, 42
weight-for-length or -height, 8, 19, 36, 37, 39, 40, 42, 43-44, 138, 140, 142
well-child visits, 5, 8, 35, 37, 38, 39, 45
WHO charts, 8, 35, 36, 38-40, 42
H
Head Start (see also Early Head Start), 26, 65
Health care providers
counseling parents/caregivers, 13, 14, 107, 121, 123-124
growth monitoring, 4, 5, 8, 35-44, 45
perceptions of competence to treat obesity, 42-43
training, 10, 35, 42, 67, 72-76, 107, 121
Healthy eating (see also Breastfeeding; Diet of U.S. children; Eating behavior)
access to affordable healthy foods, 6, 12-13, 23-24, 27-28, 85, 101-106, 159
adults eating with children, 98, 99, 100, 101
CACFP standards, 5-6, 11, 13, 30, 87, 93, 94, 95, 101, 103-105, 107
child care settings, 5-6, 11, 23, 93, 101, 103, 107
communicating with parents, 102, 107
dietary guidelines for children under 2 years, 6, 12, 97-98
discretionary calories, 94, 96, 97, 158
drinking water, 11, 19, 93, 97
family-style service, 12, 98, 100, 101, 107
feeding cues, 12, 92, 98, 99, 100
fruit juice, 97
goals, 85
information and educational resources, 102
low-income urban neighborhoods, 105-106
nutrition assistance programs and, 12-13, 87, 90, 103
plates and utensils, 100
rationale for recommendations, 94-97, 98, 99, 101, 103-106, 107
recommendations, 2, 5-6, 11-13, 93, 97, 98, 101, 107
responsive feeding, 6, 12, 21-22, 85, 98-101, 102, 161
self-regulation, 6, 12, 98, 99, 100, 101, 107
toddlers and preschoolers, 98
training professionals, 13, 107
Healthy, Hunger-Free Kids Act of 2010, 29
High-density lipoprotein (HDL) levels, 48
Hispanics/Latinos, 19, 20, 87, 124
Home settings
low-income families, 28
screen time, 14, 15, 120, 122, 124
Home visitation programs, 11, 22, 75, 87, 90, 140, 160-161
I
Implementation of policies
interaction with parents, 22-23
parent role in, 23
training of providers, 27
Individuals with Disabilities Education Act, 74
Infant formula
bottle-feeding guidelines, 90-92
WHO International Code of Marketing of Breast Milk Substitute, 11, 86
Infants (see also Breastfeeding)
adult interactions, 61, 62, 63
bottle-feeding guidelines, 12, 90-92
complementary solid foods, 12, 21, 87, 92-98
cow’s milk, 91
crib, car seat, and high chair use, 70-71
defined, 159
gross motor development, 62
holding vs. propping bottles, 12, 91, 101
obesity in, 62
physical activity, 5, 8-9, 60, 61-63, 70-71, 74-75
physical environment for, 62-63
plagiocephaly, 71
rate of weight gain, 43
restrictive equipment, limiting use of, 70, 74-75
screen time, 120
SIDS, 71
soothing techniques, 140
standards for child care, 101
stroller, swing, and bouncer seat/chair use, 70-71
Interagency Working Group on Food Marketed to Children, 125
K
Kaiser Family Foundation, 120
L
Lead, 154
Low-income neighborhoods
access to healthy foods, 27-28
M
Marketing/advertising (see also Social marketing campaigns)
and eating behavior, 119, 121, 122, 125, 128
expenditures for food marketing, 121
exposure levels of young children, 121
goals, 119
self-regulatory advertising initiative, 122
unhealthy foods and beverages, 4, 14, 27, 122, 125
Massachusetts, child care regulation, 30
Milk, flavored, 96-97
N
National Association for Sport and Physical Education, 74
National Association for the Education of Young Children, 74
National Health and Nutrition Examination Survey (NHANES), 19, 154
National Health and Safety Performance Standards, 68
National Longitudinal Survey of Youth, 47
National Resource Center for Health and Safety in Child Care and Early Education, 30
National School Lunch Program, 29, 104
National Sleep Foundation, 137, 158
New York City Department of Health and Mental Hygiene, 106
North Carolina, child care regulation, 30
Nutrition assistance programs, 4 (see also specific programs)
and child care licensing, 29
funding, 103
and healthy eating, 12-13, 87, 90, 103
interagency coordination, 29
maximizing participation, 12-13, 103
O
Obesity
chronic diseases associated with, 94
and gut microflora, 154
racial/ethnic differences, 19, 20
Obesogenic environment, 160
Organophosphates, 153
Overweight
chronic diseases associated with, 94
“growing out of it,” 1, 19
racial/ethnic differences, 19, 20
P
Parent and family roles, 3-4, 13, 23 (see also Home settings)
advocacy, 75-76
misperceptions of excess weight, 37-38
physical activity, 75-76
Parental weight status
and childrearing practices, 46
and growth monitoring, 8, 37, 42, 44
and obesity risk, 8, 37, 42 (see also Prenatal influences)
Patient Protection and Affordable Care Act of 2010, 88
PCBs, 153-154
Physical activity
active play, 21, 67-68, 102, 157
adult interactions, 61
Animal Trackers intervention, 65
behavioral mapping, 68-69
built environment and, 5, 9, 23, 27, 61, 62-63, 65-70
in child care settings, 5, 8-9, 29, 61, 65-66, 70
children with disabilities, 5, 9, 61, 67, 69-70, 74
circuit training and endurance activities, 65
and cognitive development, 67
communication with parents about, 5, 10, 73, 75-76
defined, 161
environmental interventions, 65-66
family-based interventions, 64-65
goals, 59
Healthy People 2020 objectives, 29, 123
infants, 5, 8-9, 60, 61-63, 70-71, 74-75
information and resources on, 74
light levels of, 9, 61, 63-64, 65-66, 68-69, 159
in low-income neighborhoods, 27-28
measurement of, 63-64
moderate levels of, 9, 29, 61, 63, 64, 65-66, 67, 68-69, 73-74, 160
“move and learn” activity curriculum, 65
neighborhood and community venues, 68-69
outdoor activities, 5, 8, 9, 61, 62, 65, 66-67, 68, 69-70, 75, 76
parental role, 75-76
Physical Activity Guidelines for Americans, 60, 63
potential actions, 61
Public Playground Safety Handbook, 68
and punishment, 61
racial/ethnic differences, 69
recommendations, 2, 5, 8-9, 60-61, 67
screen time and, 123
social marketing campaign, 127-128
standards for child care, 29, 60-61, 64, 68, 70, 71
structured, 9, 61, 65, 74, 162
toddlers and preschoolers, 9, 61, 63-64, 75
training health and education professionals, 10, 67, 72-76
vigorous levels of, 9, 29, 61, 63, 64, 65-66, 67, 68-69, 73-74, 162
and weight gain, 59, 60, 63, 67, 70
Physical Activity Guidelines for Americans, 60, 63
Plagiocephaly, 71
Polyfluoroalkyls, 154
Preeclampsia, 51-52
Prenatal influences, 4-5
adiposity in children, 50
chemicals, drugs, and microorganisms, 24, 47, 153-154
diet and exercise interventions, 49, 50
gestational diabetes, 46, 49-51
gestational weight gain, 45, 46, 47-49, 51
intergenerational cycle, 46
metabolic consequences of maternal weight, 46-47, 50, 51
potential interventions, 47
prepregnancy weight, 24, 45-47, 48, 51
research challenges, 48, 49, 51
Prevalence
gestational diabetes, 50
obesity/overweight in young adults, 138
obesity/overweight in young children, 1, 19, 20, 43-44, 63, 140
prepregnancy overweight, 46
Professional training
and activity levels of children, 73-74
certification and continuing education from national organizations, 73
for counseling parents and caregivers, 6-7, 10, 13, 72-73, 107, 121
defined, 161
rationale for recommendations, 73-76
regulatory requirements, 73
staff development in child care settings, 107
Public Playground Safety Handbook, 68
Q
Quality Rating and Improvement System (QRIS), 28, 29
R
Rational for prevention in early childhood, 20-21
Recommendations
decreasing sedentary behavior, 9-10, 70
formulation approach, 2, 26-28, 149-151
growth monitoring, 5, 8, 38-44
healthy eating, 2, 5-6, 11-13, 93, 97, 98, 101, 107
implemention strategies, 2-3
physical activity, 2, 5, 8-9, 60-61, 67
revising, 7
screen time for 2- to 5-year-olds, 6, 13-14, 120, 124
social marketing prevention campaigns, 14, 126
training professionals to counsel parents/caregivers, 10, 13, 15, 72-73, 107
Reconciliation Act of 2010, 88
Regulation of child care (see Standards for chld care)
Research on obesity prevention
barriers, 25
Responsive feeding, 6, 12, 21-22, 85, 98-101, 102, 161
Risk of later obesity, 19-20, 43-44, 45, 47-48
S
School Breakfast Program, 104
Screen time
in bedrooms and sleep areas, 14, 15, 120, 124
in child care settings, 13, 29-30, 72, 121, 122
and cognitive development, 124
coordination between parents and caregivers, 13, 121, 122
counseling parents/caregivers, 13, 121, 124
exposure trends, 21, 119, 120, 122
goals, 119
Healthy People 2020 objectives, 123
at home, 14, 15, 120, 122, 124
and physical activity, 123
race/ethnicity and, 124
rationale for recommendations, 121-124
recommendations, 6, 13-14, 120, 124
research challenges, 120
and sleep duration, 137
standards, 29-30
television advertising, 6, 119-120, 121, 122, 125
training professionals to counsel parents/caregivers, 13, 121
and weight gain, 72
Sedentary behavior (see also Physical activity)
electronic media use and, 72, 75
measurement of, 71-72
quality of child care center and, 72
rational for recommendations, 70-72
standards for child care, 29-30, 70
Self-regulation by young children
caloric intake, 6, 12, 98, 99, 100, 101, 107
Sleep
and adiposity, 138
adverse health outcomes of deficits, 135-136, 137-138
and BMI, 137-138
in child care settings, 6-7, 15, 136
circadian misalignment, 138-139
counseling parents and caregivers on, 6-7, 15, 142
developmentally appropriate durations, 137, 158
disturbances and disorders, 135, 139
and eating behavior and diet, 138
epidemiologic evidence, 135-136
goal, 135
interventions, 140-142
and neurocognitive functioning, 139
parental behavior and, 139
and physical activity, 137
position for infants, 71
racial/ethnic differences, 124, 135
and screen time, 137
self-regulation by young children, 15, 136, 142
training professionals to counsel parents/caregivers, 15, 136-137
trends in young children, 6-7, 21, 135
and weight status, 138
Sleeping and Intake Methods Taught to Infants and Mothers Early in Life (SLIMTIME), 140-141
Smoking, maternal, 45, 51-52, 153
Social marketing campaigns
5-4-3-2-1 Go!, 128
coordination with health care providers and community service agencies, 128
core messages, 127
costs, 127-128
defined, 126
examples of successful programs, 126, 127-128
format of information, 128
key elements, 126
parents as targets, 128
VERB, 127-128
Special Supplemental Nutrition Program for Women, Infants, and Children (see WIC program)
Standards for child care
accreditation of programs, 28-29
fostering adoption of, 28-29
incentives for adoption of state voluntary standards, 29
infants, 101
mandatory regulation, 29-30
nutrition program funding and, 29
outreach campaigns, 28
physical activity, 29, 60-61, 64, 68, 70, 71
Quality Rating and Improvement System, 28, 29
screen time, 29-30
sleep duration, 136
time spent in confining equipment, 71
training for providers, 73
Statement of task, 2, 3, 4, 18
Study approach
evidence gathering and assessment, 24-26
exploring child care standards, 28-30
formulating recommendations, 2, 26-28
Sudden infant death syndrome (SIDS), 71
Sugar-sweetened beverages, 19, 96, 97, 158, 162
Summer Food Service Program, 104
Supplemental Nutrition Assistance Program, 13, 103, 104
Surgeon General’s Call to Action to Support Breastfeeding, 87-88
Surgeon General’s Vision for a Healthy and Fit Nation, 60
T
Ten Steps to Successful Breastfeeding, 89, 91
Tennessee, child care regulation, 30, 101
Texas, child care regulation, 30
Toddlers/preschoolers (see also Healthy eating)
hunger and fullness cues, 98-101
physical activity, 9, 61, 63-64, 75
sedentary behavior, limiting, 70
sleep duration, 137
stroller use, 70
Training (see Professional training)
Type 2 diabetes, 46, 50, 94, 96
U
Underweight, defined, 40
United Nations Children’s Fund (UNICEF), 89, 157
University of Colorado Anschutz Medical Campus, 102
University of Idaho, 102
U.S. Department of Agriculture
child care nutrition standards, 29, 94
Cooperative Extension programs, 22
dietary guidelines for children under 2, 12, 97, 158
information and educational resources, 102
and marketing standards, 14, 125
nutrition assistance programs, 13, 22, 75, 103, 104
U.S. Department of Health and Human Services (HHS), 11, 12, 23, 29, 86, 97, 126, 158
V
VERB campaign, 127-128
W
Washington, DC, child care regulation, 30
Washington State University, 102
Weight-for-length or -height, 8, 19, 36, 37, 39, 40, 42, 43-44, 138, 140, 142
Weight gain
gestational, 45, 46, 47-49, 51
and neurocognitive outcomes, 44
and obesity risk, 44
preterm infants, 44
rate in children, 8, 19, 35, 37, 42, 43-44
sugar-sweetened beverages and, 96
WIC program, 11, 13, 22, 26, 36, 37, 75, 87, 90, 103, 104, 160
Workplace breastfeeding policies, 11, 28, 87, 88-89, 90
World Health Organization (WHO)
Baby-Friendly Hospital Initiative, 11, 86, 88, 89, 90, 157
growth charts, 8, 35, 36, 38-39, 42
International Code of Marketing of Breast Milk Substitute, 11, 86