September is National Childhood Obesity Month. Obesity rates among children in the U.S. have doubled since 1980 and have tripled for teens. About 19.7% of children ages 2 to 19 are considered obese.

Children who take in too many calories and don't get enough exercise or sleep are at risk for obesity. Efforts to prevent obesity should begin early.

Children who have obesity have a higher risk of developing various health conditions including:

• High blood pressure
• High cholesterol
• Type 2 diabetes
• Sleep apnea
• Non-alcohol-related fatty liver disease
• Obesity-related depression

Prevention is important. There are chronic diseases and conditions associated with weight gain. Obesity is hard to treat.

If you are concerned about your child's weight, talk with their healthcare provider. They can assess the health risks related to excess weight.

Tips For Preventing Childhood Obesity

1. Model a healthy eating pattern

• Focus on good health, not a certain weight goal. For example, treatment goals may include improving self-esteem, missing less school, and taking part in events such as a walkathon.
• Be a role model. Parents who eat healthy foods and participate in physical activity set an example. A child is more likely to do the same.
• Focus on the family. Do not treat overweight children differently. Involve the whole family and work to gradually change family eating habits and activity levels.
• Involve children in planning, shopping, and preparing meals. Use these activities to understand children's food preferences, teach children about nutrition, and encourage them to try a variety of foods. Focus on maximum nutrition, including vegetables and fruits, whole grains, lean protein foods, and low-fat and fat-free dairy products.
• Avoid labeling foods as "good" or "bad." All foods in moderation can be part of a healthy diet.
• Encourage children and teens to eat only when hungry and to eat slowly.
• Don’t use food as a reward or withhold food as a punishment.
• Eat meals together as a family. Determine what food is offered and when, and let the child decide whether and how much to eat.
• Encourage children and teens to drink water rather than beverages with added sugar, such as soft drinks, sports drinks, and fruit juice drinks.

2. Be smart about snacking

Buy fewer high-calorie, low-nutrient foods. Help children understand that high-fat treats and sweets (such as candy, cake, and cookies) are not everyday foods. Don't deprive children of occasional treats, however. This can make them more likely to overeat. Plan healthy snacks at specific times.

When providing your kids with snacks, aim for foods that contain both protein and fiber to ensure that they are both filling and nutritious. Examples of healthy snacks include:

• Low-fat cheese and pear slices
• Low-fat yogurt, fruit, and nuts
• Raw veggies with yogurt dip
• Nuts and raisins
• Trail mix including nuts, dried fruit without added sugars, whole-grain pretzels, and low-sugar dry cereal
• Celery sticks filled with almond or peanut butter
• Reduced sodium sliced turkey breast wrapped around apple slices
• Fruit smoothies
• Baked tortilla chips dipped in salsa

3. Replace screen time with family time

During childhood, too much screen time can lead to poor sleep, weight gain, poor mental health, and lower grades in school. Limiting screen time can allow for more family activity time and may remove cues to eat unhealthy food.

Limit time spent watching TV, playing video games, and being online for fun (as opposed to distance learning) to no more than 2 hours a day. Discourage eating meals or snacks while watching TV. Eating in front of the TV may make it difficult to pay attention to feelings of fullness and may lead to overeating.

4. Move more as a family

According to the American Academy of Pediatrics, preschool-aged children should get at least 180 minutes of physical activity each day. Children and teens from ages 4 through 17 should get at least 60 minutes of physical activity each day.

Encourage physical activity. Start walking the dog as a family, explore parks together, complete chores as a group while dancing to music, or have a weekly sports night where everyone gets a turn shooting the basketball.

5. Set regular sleep routines

Good sleep helps prevent type 2 diabetes, obesity, injuries, and problems with attention and behavior. Children who don't get enough sleep are at risk for unhealthy weight gain. Lack of sleep leads to lower activity levels and increased hunger and calorie intake.

Preschoolers need 10–13 hours of sleep per day, including naps. Children 6–12 years old need 9–12 hours of uninterrupted sleep a night, and youth 13–17 years old need 8–10 hours.

Turning off screens an hour before bed and removing screens from children's bedrooms can help reduce screen time and improve sleep. Setting a regular sleep and wake schedule, including on weekends, can help children sleep better.

Talk to your child’s healthcare provider about how you can help support a healthy lifestyle.

New York State Department of Health: Preventing Childhood Obesity: Tips for Parents https://www.health.ny.gov/prevention/nutrition/resources/obparnts.htm#:~:text=Healthy%20meals%20and%20snacks%20provide,eating%20habits%20for%20a%20lifetime.

CDC: Preventing Childhood Obesity: 6 Things Families Can Do
https://www.cdc.gov/obesity/family-action/index.html

Phillipp Schwarzfischer, MSc et al. 2019. Physical Activity and Sedentary Behavior From 6 to 11 Years. Pediatrics, Volume 143, Issue 1.

Shalini Paruthi, MD et al. 2016. Consensus Statement of the American Academy of Sleep Medicine on the Recommended Amount of Sleep for Healthy Children: Methodology and Discussion. Journal of Clinical Sleep Medicine, Volume 12, Issue 11