Fight against obesity should start early in life

There was a time when the term "baby fat" seemed harmless, a playful nod to carrying a little extra weight. But in these days of an obesity epidemic, that description is no laughing matter, and the time to get serious about weight gain comes at a younger age than many parents might imagine.

A June report by the Institute of Medicine notes that, contrary to popular belief, some children do not grow out of their baby fat. In fact, the report said research shows that excessive weight gain early in life can alter developing metabolic and behavioral systems, raising the risk of obesity and chronic diseases later in life.

About one in 10 children from infancy to age 2 is overweight or obese, according to the IOM report on preventing obesity in early childhood. The figure increases to about 20% of children ages 2 through 5. Among children in that age group, the rate of excess weight and obesity has doubled since the 1980s. About 17% (12.5 million) children and adolescents ages 2 to 19 are obese.

As part of its report, the IOM issued recommendations for health care professionals, preschools, government agencies and others combating obesity among the very young. The IOM advises that health professionals should measure infants' weight and length and the body mass index of young children at each well-child visit. Children at risk for obesity should be identified and parents should be told about the risks related to excessive weight. Among other recommendations: Limit TV and other media use; promote physical activity for children from birth to age 5; and encourage healthy sleeping habits that are age-appropriate.

Rightly so, healthy eating habits were urged. The Dept. of Health and Human Services and Dept. of Agriculture were called on to establish dietary guidelines for children from birth to age 2. At the same time, federal agencies should continue working to create and monitor the implementation of voluntary nutrition and marketing standards for food and beverages marketed to children, according to the IOM.

The week before the IOM's June 23 report, the AMA's House of Delegates tackled childhood obesity issues during its annual policymaking meeting. Delegates adopted policy calling for the AMA to support and encourage corporate social responsibility in the use of marketing incentives that promote healthy childhood behaviors. The action comes as food companies spend about $2 billion a year marketing foods and beverages to children, said the Center for Science in the Public Interest. (By happy coincidence, the 2,200-restaurant Jack in the Box chain announced in June that it was dropping toys from its children's meals.)

The AMA policy says that fast-food restaurants should establish competitive pricing between nutritious foods and less-healthy options in children's meals. It also calls for the Association to work with the appropriate organizations and corporations to educate health professionals and the public about healthy food choices in fast-food restaurants. In addition, delegates said the AMA should support parental responsibility to encourage healthy eating among children.

Maintaining a healthy weight can be a challenge at any age, but children are a special case. It's adults -- both parents and, to a very large degree, those who market meals -- who make the decisions regarding the feeding and future well-being of America's children. The new AMA policy and the IOM report provide timely guidance on a situation that children are too young to understand, but that adults should recognize they can't ignore.