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.
“How active is your child at day care?” researcher Sara Benjamin asked an audience of early childhood experts. The guesses varied from 15 minutes to an hour, but none were optimistic.
An average eight-hour day of childcare, Benjamin explained, contains “less than one hour” of moderate to vigorous physical activity. This is according to her study, which she previewed today at the Heathy Kids, Healthy Future conference.
Benjamin’s study aims to assess a new regulation in Massachusetts that requires all childcare centers to provide 60 minutes of physical activity per day. The centers she measured in Massachusetts – and a control group in Rhode Island – all fell short.
In Massachusetts, children were sedentary (not including eating or sleeping) for 150 minutes per day, and spent 41 minutes engaging in physical activity. In Rhode Island, children fared worse. They spent 165 minutes – more than 2.5 hours – in sedentary activities with only 29 minutes out of an eight-hour day devoted to physical activity. The study methodology considered all activity more vigorous than walking as qualified physical activity.
For the three-quarters of US children who attend day care, half of whom attend centers like the ones Benjamin measured, these findings are indicative of a worrying trend.
“Children are largely inactive,” said Benjamin. “2, 3, and 4 year-olds should be out running around.”
For parents of these children, the results may be surprising.
“When you ask parents, they think kids are very active,” Benjamin explained. “Parents would be surprised to learn how inactive their kids are in childcare.”
Read on after the jump for more photos from today’s proceedings. (Click to enlarge.)
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So warned Debbie Chang, Vice President of Policy and Prevention for Nemours, in her opening remarks at today’s Healthy Kids, Healthy Future conference in Washington, D.C. And overweight preschoolers, she continued, are at greater risk of becoming overweight adults. After laying out these sobering statistics, Chang welcomed participants to the first ever conference to examine the role of early child care in obesity prevention.
More than a convenience
Three quarters of kids under six spend part of their day in childcare. For Chang, this means that childcare “is more than a convenience – it’s a partnership.” She called for an array of programs, policies and environmental changes to make childcare a place where children eat healthier foods and get more physical activity.
She also shared the story of the Latin American Community Center in Wilmington, Del. Since partnering with Nemours, the executive director of the community center, Maria Matos, has transformed the foods the center provides for participating children. They’ve removed vending machines. They’ve cut out sugar-sweetened beverages, and now serve only water, skim and low-fat milk. They’ve eliminated fried foods altogether.
Chang used this example to implore those in the room to harness what they know, break down barriers, and spread what works. When, as Chang noted, the most commonly consumed vegetable among kids 15 to 18 months old is French Fries, there is vast potential for improvement.
“Creating the changes we want to see will take planning, direction, energy and motivation,” Chang reminded participants. “And it doesn’t end here, we have to keep it moving after we leave.”
Slides from Debbie Chang’s presentation are available here.
Today’s coverage of the Nemours conference, Healthy Kids, Healthy Future, is set to begin from Washington, D.C., at 2 p.m. today with a keynote from the Honorable Thomas Vilsack, Secretary of the U.S. Department of Agriculture. We will bring you highlights from his remarks and reactions from the participants throughout day one of the conference. Additional highlights from today’s agenda include:
- Remarks from William Dietz of CDC and Debbie Chang of Nemours to set the context for today’s discussion of obesity prevention and early child care
- Afternoon panel at 3:15 p.m. on model child care wellness policies from around the country, featuring stories of success at the state and city level
- Data on the connections between obesity, nutrition (including breastfeeding), oral health and overall health in America
You can join the conversation in the comments section and follow along via email, RSS updates and the Twitter hashtag #hkhf09. Thanks for your interest in today’s live coverage!
Live Coverage | admin | 
September 23, 2009 7:10 pm | 
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