The US is facing many challenges in controlling the childhood obesity epidemic. Despite recent efforts and some progress, one third of US children are still overweight or obese. Yet research has shown that the road to obesity begins early in life, and it is more common and difficult to address for low-income children.
Robert Whitaker, a professor of pediatrics and public health at Temple's College of Health Professions, says that even leading programs in early childhood education, like Head Start, the nation's largest federally funded education program for preschool children, are facing difficulties in their efforts to help children stay at a healthy weight.
In a study released this month in Health Affairs, Whitaker and his colleagues found that Head Start program directors felt they faced a variety of barriers to addressing obesity in children, including lack of money and time, as well as limited knowledge.
The researchers surveyed program directors from 1583 Head Start programs across the country. The directors were asked about barriers to children's healthy eating and physical activity that were faced by their program, the staff and the parents. While the majority of programs reported that they were making efforts to provide children with healthy foods and opportunities for physical activity, they did note challenges:
- Seventy-seven percent of programs reported that federal funding from USDA did not fully cover the cost of meals and snacks, and 93 percent of these programs used money from their education budgets to make up the uncovered costs;
- Eighty-three percent of program directors thought that parents did not have enough money to purchase healthy foods for their children at home;
- Forty-two percent reported that the program lacked money to buy additional physical activity equipment;
- Thirty-eight percent reported that programs lacked time in the daily schedule to increase the amount of physical activity, and 70% reported that parents did not have time to participate in physical activity with children at home;
In addition, directors noted that both staff and parents shared cultural beliefs about obesity -- such as the belief that a heavier child is a healthier child -- that could also be a barrier to obesity prevention efforts in Head Start.
"For four decades Head Start has set the standard for early childhood education," said Whitaker, who last fall released a study on Head Start's obesity prevention efforts, finding that most programs exceeded the federal recommendations for healthy eating and physical activity. "But without additional resources, Head Start programs might not be able to overcome the challenges they face in making meaningful and suitable changes to address obesity," he said.
Whitaker and his team made suggestions for how Head Start could use additional federal resources to address barriers. The noted that Head Start programs need more funding to: provide healthy meals and snacks; increase training and technical assistance to help teachers learn how to encourage children's healthy eating and physical activity; and develop staff wellness programs to support teachers in changing their own behaviors so that they can act as positive role models for children.
"The traditional emphasis in childhood obesity prevention has been on interventions targeted directly at children. However, I think we are overlooking the needs of the adults who care for young children," said Whitaker. "To prevent obesity early in life, children might be better served by placing more emphasis on supporting teachers, child care providers, and parents to help these adults emotionally engage children, serve as healthy role models, and create healthy environments," he said.
Last month, Michelle Obama launched the "Let's Move" campaign, an initiative designed to stop the epidemic of childhood obesity within a generation. The suggestions of Whitaker and his colleagues for addressing these barriers in Head Start mirror some of the key goals of that campaign. For example, the campaign calls for providing healthier foods in schools through the USDA's child nutrition programs, which also provide the meals and snacks for Head Start.
The campaign also calls for support for parents to make healthier choices for their children. Whitaker said it's imperative to extend this support to teachers and health care providers as well.
"By funding efforts like training assistance and wellness programs for Head Start teachers, we are encouraging the teachers to be healthy, with the added bonus of helping to prevent obesity in children," he said.
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