Could Your Preschooler Be at Risk for Obesity?

More than 12.5 million children are overweight in the United States, according to the Office of the Surgeon General. This rising statistic, which cuts across age, race, and gender has garnered a lot of national attention, including that from First Lady Michelle Obama. The first lady's new Let's Move! campaign targets schools, parents, the medical community, and community leaders to aim for a healthier America -- starting with changing the way families and children think about food and exercise. And this growing epidemic doesn't just affect older kids and adolescents. According to a study by Gerber, nearly one in four kids between the ages of 2 and 5 are overweight or obese.

If you're unsure whether your child's weight is where it should be, ask your doctor. Pediatricians use body mass index (BMI) for kids as young as 2 years old as an indicator for body fatness, according to the Centers for Disease Control (CDC). BMI is simply weight in pounds multiplied by 703 and divided by height in inches. This number is compared to other kids of the same age and gender, known as BMI-for-age. If your child's BMI is between the 85th and 94th percentile, he is overweight. If he is in the 95th percentile or above, he is considered obese.

Sarah Hampl, M.D., Medical Director of Weight Management Services at Children's Mercy Hospitals and Clinics in Kansas City, Missouri, says there are multiple contributors to childhood obesity. Simply put, children who consume more calories than they burn are at risk of obesity. And diets with high amounts of fast food and sugary drinks are a leading cause. Kids with unhealthy weights tend to spend more time in front of the computer and TV (and less time being physically active), don't get the recommended amounts of fruits and vegetables and don't get enough sleep. (Remember, your preschooler needs 11-12 hours of sleep every night.) Your child also has an increased risk of obesity if you smoked during your pregnancy or gained more than your advised prenatal weight.

Andrea Pennington, M.D., C.Ac., president of Pennington Empowerment Media, LLC, and chief medical officer for Logical Images, Inc., has seen Type 2 diabetes in children as young as 8. "These kids are eating food that is not nourishing, and they don't process energy well," Dr. Pennington says. A child's brain needs nutrients, and without a balanced diet, kids might have trouble learning and developing other cognitive functions. According to Dr. Hampl, in the long run, an overweight or obese child could develop liver disease, sleep apnea, high blood pressure, and prediabetes.

If you sense your little guy might be overweight, see your pediatrician. Marilyn Tanner-Blasiar, M.H.S., R.D., L.D., a clinical pediatric dietitian at St. Louis Children's Hospital says, "Overweight children often have high cholesterol and triglyceride levels and hypertension." These are all considered risk factors for diabetes and heart disease. Your child should have his glucose levels tested as soon as his BMI is in the 85th percentile and he has one or more of the above risk factors, including high blood pressure. Tanner-Blasiar says nurses have checked glucose levels in children as young as 2 years old.

Shelli Cornell, a mother of four, decided it was time to change what her kids ate when she felt they were overweight and at risk for health problems, such as diabetes. She also didn't want to see them go through the emotional turmoil of being teased at school. One morning she gave her kids toast, eggs, and fruit instead of their usual store-bought breakfast pastry and they ate it without complaints. "Whatever I buy is what they eat. They can't go out and buy that food, so if I keep it out of the house they won't be eating it," Cornell says. She says after making these changes her son is also more active.

Small changes in your child's diet can make a difference. Dr. Hampl suggests using your child's hand to measure food portions. Her fist is the perfect size for a serving of fruits, veggies, and grains. And her serving of protein should fit in the palm of her hand.

Drinks: Give your toddler low-fat or nonfat milk or water. If you also give your kids juice make sure it's always 100-percent fruit juice and limit the amount to no more than 4 ounces a day. Hampl discourages parents from giving kids soda. "It has no vitamins or minerals and does nothing to help your kid grow," she says.

Snacks: You can give your preschooler an afternoon or bedtime snack. Just make sure it's something healthy such as fruit, veggies and dip, or yogurt. Stay away from cookies, chips, crackers, and other processed foods high in fat and sugar.

Kids love to play outside. In fact, kids ages 2-5 need several hours a day to run around outside. In the winter you and your toddler can dance or play games to get up and moving. If the weather is nice let him play at a playground or a park or take walks and explore, but don't feel like you have to sign up for organized sports just to get him running and moving. "They need free play. They will have lots of time for organized sports later," Dr. Hampl says. Of course, the whole family can exercise together. If your child sees you enjoying physical activities he's more likely to do them too. "This is a very critical time in children's lives to develop healthy eating and exercise habits that will follow them for the rest of their lives," Dr. Hampl says.

• Don't reward with food. Dr. Hampl recommends rewarding with a nonfood item such as reading a book or taking a walk. Your little one craves your attention. Time spent with you is the greatest reward for her.
• Limit screen time to less than two hours per day. This includes TV, computer, video games, or other electronic devices.
• Avoid antifat messages. Dr. Pennington suggests tying weight to people your child admires or things she wants to do. "Talk about eating healthy to get energy for things they want to do, like be an astronaut," Pennington says.

If your child needs some help with his weight, Wendy Slusser, M.D., M.S., from the UCLA Center for Healthier Children, Families, and Communities, suggests making a family shift to a healthier lifestyle. Go grocery shopping together, cook together, and eat together. Studies suggest that families who eat at home together seven days a week are 40 percent less likely to be overweight than families who don't. So eat in, and try to plan family outings not related to food, such as going to the playground, walking to preschool, or getting out in nature. Just remember to make food and fitness a healthy and fun part of everyday life.

Copyright 2010 Meredith Corporation.