Early Childhood Obesity Prevention Policies (2011) / Chapter Skim
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4 Healthy Eating
4 Healthy Eating
Pages 85-118
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A child develops food preferences by responding to what he or she is fed and observing adults; the availability of food in the immediate environment also plays a role. Because food offered to young children is determined by caregivers, they should make every effort to introduce children to healthy foods and lifestyle 85
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GOAL: PROMOTE THE CONSUMPTION OF A VARIETY OF NUTRITIOUS FOODS, AND ENCOURAGE AND SUPPORT BREASTFEEDING DURING INFANCY Recommendation 4-1: Adults who work with infants and their families should promote and support exclusive breastfeeding for 6 months and con tinuation of breastfeeding in conjunction with complementary foods for 1 year or more. Potential actions include • hospitals and other health care delivery settings improving access to and availability of lactation care and support by implementing the steps outlined in the Baby-Friendly Hospital Initiative and following American Academy of Pediatrics policy recommendations; • hospitals enforcing the World Health Organization's International Code of Marketing of Breast Milk Substitute (This step includes ensuring that hos pitals' informational materials show no pictures or text that idealizes the use of breast milk substitutes; that health professionals give no samples of formula to mothers [this can be complied with through the Baby-Friendly Hospital Initiative]
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The first Institute of Medicine (IOM) report on childhood obesity prevention takes a similar position (IOM, 2005)
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. However, many women still Early Childhood Obesity Prevention Policies 88
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and the United Nations Children's Fund (UNICEF) to encourage and recognize hospitals and birthing centers that offer an optimal level of care for infant feeding.
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The literature suggests the fol lowing guidelines on bottle feeding: Early Childhood Obesity Prevention Policies 90
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Alternative soothing strategies, such as 91 Healthy Eating
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Early Childhood Obesity Prevention Policies 92
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. Recommendation 4-2: To ensure that child care facilities provide a variety of healthy foods and age-appropriate portion sizes in an environment that encourages children and staff to consume a healthy diet, child care regula tory agencies should require that all meals, snacks, and beverages served by early childhood programs be consistent with the Child and Adult Care Food Program meal patterns and that safe drinking water be available and acces sible to the children.
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Whole grains, fruits, Early Childhood Obesity Prevention Policies 94
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95 Healthy Eating
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Clear and undisputed evidence shows that children benefit from consuming a diet rich in low- or nonfat milk and other dairy products. Flavored milk should be avoided as it contains added calories in the form of high fructose corn syrup Early Childhood Obesity Prevention Policies 96
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. Providing drinking water as an alternative to sugar-sweetened beverages and fruit juice helps reduce discretionary energy intake and resultant obesity risk.
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These recommendations could help inform effective obesity prevention efforts. GOAL: CREATE A HEALTHY EATING ENVIRONMENT THAT IS REPONSIVE TO CHILDREN'S HUNGER AND FULLNESS CUES Recommendation 4-4: State child care regulatory agencies should require that child care providers and early childhood educators practice responsive feeding.
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In addition, adults should sit with children and eat the same foods. In so doing, adults can model the consumption of healthy foods (Nicklas et al., 99 Healthy Eating
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SOURCE: Connecticut State Department of Education, 2010; Fletcher et al., 2005. Early Childhood Obesity Prevention Policies 100
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GOAL: ENSURE ACCESS TO AFFORDABLE HEALTHY FOODS FOR ALL CHILDREN Recommendation 4-5: Government agencies should promote access to affordable healthy foods for infants and young children from birth to age 5 in all neighborhoods, including those in low-income areas, by maximizing participation in federal nutrition assistance programs and increasing access to healthy foods at the community level. 101 Healthy Eating
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. Early Childhood Obesity Prevention Policies 102
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Rationale Federal nutrition assistance programs provide an existing infrastructure for sup porting food access for low-income families, who are at greatest risk for food insecurity. The federal government funds several nutrition assistance programs that aim to prevent hunger and improve dietary quality among families with young children (Box 4-6)
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• The Child and Adult Care Food Program is a nutrition education and meal reimbursement program helping providers serve nutritious and safely prepared meals and snacks to children and adults in day care settings. • The Farmers' Market Nutrition Program provides fresh fruits and vegetables from local, certified farmers' markets to WIC recipients.
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Box 4-7 describes an effort undertaken by New York City to increase access in underserved communities by licensing 1,000 Green Carts to sell reasonably priced fresh fruits and vegetables in its poorest neighborhoods. 105 Healthy Eating
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. Early Childhood Obesity Prevention Policies 106
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Ongoing staff development in child care settings could include training on planning healthy meals, serving as a role model for healthy eating, creating a healthy mealtime environment, and leading nutrition education activi ties for children. The IOM report on standards for the CACFP also recognizes the need for training and technical support for providers and suggests paths for devel oping their competencies and skills (IOM, 2011a)
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Annual Review of Nutrition 19:41-62. Early Childhood Obesity Prevention Policies 108
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Journal of the American Dietetic Association 99(12)
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:S91-S97. Early Childhood Obesity Prevention Policies 110
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Nutrition Link. Publication of the School Nutrition Services Dietetic Practice Group, American Dietetic Association.
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Washington, DC: The National Academies Press. Early Childhood Obesity Prevention Policies 112
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2009. Local Government Actions to Prevent Childhood Obesity.
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:21-33. Early Childhood Obesity Prevention Policies 114
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2010. Position of the American Dietetic Association: Child and adolescent nutrition assistance programs.
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. Early Childhood Obesity Prevention Policies 116
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2009. A national sur vey of obesity prevention practices in Head Start.
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