“Preschool is too Late”

Lynn Silver

As a pediatrician, Lynn Silver was shocked when she found out that a quarter of kids in New York City are obese by age two. As assistant commissioner of the NYC Department of Health and Mental Hygiene, she knew she had to do something, and that starting in preschool would be too late.

In 2006, the city issued regulations on nutrition, physical activity and screen time in daycare centers. They include:

• Prohibiting access to sugar-sweetened beverages
• Limiting juice to just 6 ounces per day
• Prohibiting trans fats and reducing sodium in foods
• Ensuring kids get at least an hour of physical activity per day
• Reducing time spent watching TV

Before implementing the policies, the city began training and equipping daycare centers, pre-schools and K-3 teachers — starting in those communities at greatest risk. To date, they’ve trained over 10,000 daycare staff members at nearly 1,400 sites.

Early evaluation indicates that compliance with beverage, physical activity, and TV requirements is high. And while some standards are more difficult to evaluate, such as those regarding specific nutrients like sodium and the quality of physical activity, early signs are encouraging.

The CDC and the Robert Wood Johnson Foundation are funding further evaluations of policy compliance, along with direct observations of participating daycare centers. And the city has begun BMI assessments for students entering kindergarten, to examine the direct impact of these policy changes.

Silver pointed out that the city requirements were discussed, approved and implemented without controversy.  When asked why she thought this might be, she replied that it could be “because we started our training and support first, before enacting the requirements,” emphasizing that engaging daycare directors first could be key to keeping kids active – and healthy.

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