Early childhood health is foundational to health throughout the life course. The rising incidence of obesity poses a significant challenge to those who work with and care for young children and their families.  Mounting evidence points to the importance of focusing on intrauterine life, infancy and the preschool years to establish long-term regulation of energy balance.

The U.S. Centers for Disease Control and Prevention’s Pediatric Nutrition Surveillance System (PedNSS) is a nationally compiled obesity surveillance system. In the U.S. population, the prevalence of obesity for children 2 to 5 years of age is 13 percent.  Findings from the National Health and Nutrition Examination Survey revealed that the obesity rate increased from 5.0 percent to 10.4 percent in children aged 2-5 years,  and from 6.5 percent to 19.6 percent among those aged 6-11, from 1976-80 to 2007-2008. Identifying effective interventions encompassing behavioral, environmental and policy strategies is key to addressing and preventing the growing problem of childhood obesity.

Several risk factors are associated with preventing childhood overweight and obesity. However, there is little guidance on effective, comprehensive approaches to address this growing problem. This article provides a very brief summary of the factors associated with early childhood obesity and reviews current guidelines and best practices for assessment, treatment and prevention of obesity, with special focus on the child care sector.

Three studies funded by the Colorado Department of Public Health and Environment contributed to and provided the foundational inputs for early childhood obesity research: Medical Provider Scan (2007, Dr. Kathryn Bird); Staff Perceptions Survey and Interviews (2008, Dr. Laura Bellows, survey of child care providers); Child Care Provider Environmental Scan (2009, Dr. Cynthia Gillette Dormer). Building upon these foundational studies, CDPHE and M. Colleen Domer, MS, RD, conducted a two-phased early childhood obesity prevention project. Phase One included a comparative analysis of the Colorado Child Care Champions Best Practices and other national recommendations and guidelines, and a thorough review of research-based literature. Phase Two included the findings from Phase One in a survey of state and local programs in Colorado to inventory activities related to early childhood obesity prevention.

For Phase One, summary statements, quality, consistency, quantity, impact, ability to generalize and grade of evidence for each research question were summarized onto a worksheet to determine evidence grade.  Factors were grouped by category (Figure 1. Prenatal, Lifestyle, Infant Feeding Practices, Energy Intake, Energy Output, and Family and Community).