Rates Fall Among Low-Income Preschoolers
The problem of childhood obesity, long among the country’s most intractable and vexing health issues, is at last showing signs of turning the corner.
The obesity rate for low-income preschool-age children declined between 2008 and 2011 in 19 of 43 states and territories measured, federal data showed on Tuesday.
This followed a leveling off of childhood obesity rates in recent years, a generation after they began a climb to levels that alarmed pediatricians and public-health experts and prompted national campaigns to bring the rate down.
While still very small and limited to young low-income children, the declines, said some public-health officials, suggest that moves over the past several years to help parents improve children’s diets and exercise habits might be starting to have some effect. Others said the causes of the shifting trend were difficult to know.
The obesity analysis, by the federal Centers for Disease Control and Prevention in Atlanta, was based on data from 11.6 million children age 2 to 4. The survey group included children eligible for federally funded programs of maternal and child health and nutrition, such as the Special Supplemental Nutrition Program for Women, Infants and Children, known as the WIC program.
The decline was greatest in the U.S. Virgin Islands, where the obesity rate in such children fell to 11% in 2011 from 13.6% in 2008. Drops of more than one percentage point were also seen in Florida, Georgia, New Jersey, Missouri, and South Dakota.
Thomas Frieden, director of the CDC, called the results a “bright spot” and a “tipping point.”
“For the first time in a generation, we’re seeing it go in the right direction in 2- to 4-year-olds,” he said on a conference call with reporters, calling the changes “small but statistically significant.” He was quick to add, “We’re very, very far from being out of the woods.”
Indeed, while a handful of studies have found declines among some preschool children in parts of the country, childhood obesity rates overall are holding fairly steady after more than tripling since the early 1980s. About 12.5 million children and teens, or 16.9%, were still considered obese as of 2009 and 2010, the most recent data available for this group.
Some 14.4% of low-income preschool-age children were obese as of 2011. That was down from 14.9% in 2009—the peak.
While the obesity rate for preschool-age low-income children fell in 19 of the 43 states and territories surveyed, it stayed the same in 21 and rose in three: Pennsylvania, Tennessee and Colorado.
The group measured in 2011 was larger than the 2008 group, probably as the economic downturn made more families eligible for the WIC program, and had other slight differences, the study noted. “We don’t think the increase accounts for the decrease we’re seeing,” Dr. Frieden said. “I do believe these are real.”
That obesity rates are declining among low-income preschoolers bodes well because “they are our at-risk population,” said Loretta Santilli, director of the division of nutrition for the New York State Department of Health. New York was one of the states recording a decrease in rates.
Lower obesity rates in the very young could spell more change as those children age, said Victoria Rogers, a pediatrician at the Barbara Bush Children’s Hospital at the Maine Medical Center in Portland, Maine, and the founder and director of a childhood-obesity program called Let’s Go! “Hopefully, the lower obesity trend will continue as they grow up,” she said.
Some pediatricians say the youngest children have been overlooked at times while the fight to bring obesity under control focused on school-aged children. Yet reaching the 2- to 4-year-old set is critical, they say, because overweight and obese children are five times as likely as children of normal weight to be overweight or obese when they are adults, putting them at greater risk of ills such as heart disease and diabetes.
“I’ve been saying for years, early life, early life,” said Elsie Taveras, chief of the division of general pediatrics at MassGeneral Hospital for Children, who treats children with weight issues. “Early childhood is a window of opportunity.”
Figuring out exactly what’s behind the rise in childhood obesity rates, and now the beginnings of a decline, is very tricky. But Dr. Frieden of the CDC cited what he called likely factors.
He said in 2009, changes were made to the WIC program to include healthier foods, such as more fresh fruits and vegetables and low-fat milk, and to promote breast-feeding. An increase in breast-feeding also helped bring about change, he said he believed.
Dr. Frieden also cited heightened attention called to the obesity problem by child-care centers and various programs to promote healthier eating and more physical activity.
First lady Michelle Obama, who led one such initiative called Let’s Move, issued a statement cheering the gains but noting that “tremendous work still to be done.”
Michael Tanner, a senior fellow at the Cato Institute who researches policies including health care reform and social welfare, said, “We’ve had this enormous amount of attention paid to the issue over the last several years. We’ve been talking about the need to lose weight and be healthier, and it’s finally having some impact on people.” He added, “It’s attitudinal change more than any policy. You have to want to eat healthier.”
While many communities around the country have made changes like serving better food in schools or building parks, few studies have been done to figure out what changes actually work.
Dr. Frieden said, “Though we cannot prove what are the changes in the environment and in policy that have led to that, it’s hard to believe that things like much better policies in WIC, much better policies with encouraging child care…aren’t having a big role here.”
A few small studies had previously indicated obesity levels in young children might be starting to decline. An article published in Pediatrics last year found that obesity rates in a group of children under age 6 in Massachusetts decreased between 2004 and 2008. The decline was smaller in the children on Medicaid.
Source: The Wall Street Journal
August 7, 2013
By Betsy McKay
http://online.wsj.com/article/SB10001424127887324653004578652010608206812.html
