Assessing the Strategies for Increasing Moderate to Vigorous Physical Activity in Children Birth to 5 Years of Age in the Prevention of Obesity: Systematic Review of the Literature

Purpose: A systematic review of the literature was conducted to identify the most current research studies describing the impact of increasing physical activity in children ages birth to five years for the prevention of childhood overweight/obesity. Background: From 1980 to 2001 researchers found an increased prevalence of being overweight from 6.3% to 10.0% and increased at-risk-for-overweight from 11.1% to 14.4% in children including infants less than 6 months of age. Studies have shown children who were ever overweight during the ages 24, 36, or 54 months were more than five times as likely to be overweight at age 12 years compared to those not overweight at all three referenced ages. The recently released 2008 Physical Activity Guidelines for Americans only targets people greater than 6 years of age. Currently, the 2002 National Association for Sport and Physical Education guidelines is currently the only source that specifies the types of physical activity for infants, toddlers and preschoolers. The research behind the NASPE guidelines extend from 1985 to 2000, nonetheless they were a utilized as a reference for recommended physical activity levels in young children in this systematic review of the literature. Methods: The literature review began on July 2009 and concluded in January 2010 with searches in PubMed, CINAHL and PsycHe. The search criteria included: publication date January 2000 through December 2009, English language, and children (from infancy through 5 years of age). The Medical Subject Headings Terms (MeSH) included health promotion, wellbeing, active living, physical activity, exercise, and childhood in order to expand the number of qualitative and quantitative research projects conducted in the target population. The exclusion criteria were: any disability, Prader Willi syndrome and diabetes. The challenges of this literature review included insufficient research on physical activity in the selected age group and use of different methodology across studies. Conclusion: Of the 37 journal articles included in this review, only one study stated definitively that physical activity predicts future body fat. Only six articles (16%) identified physical activity as a successful weight loss intervention when combined with nutrition education, counseling and long term trials involving entire families. However, studies involving older children and adolescents indicate correlations between the built environment, reduced physical activity and childhood obesity. The factors most influential in young children’s physical activity levels were: gender, age, social-economic status, race, ethnicity, parental or caregiver’s weight status, infant prematurity, maternal education and mental health and extended family health beliefs. Caregiver/teacher training on developmentally appropriate physical activity practices influences children’s motor skill development confidence, which impacts activity levels. There were seven distinct observational instruments/physical activity assessment tools validated for use in the target population to assist researchers in developing evidence-based strategies. These tools should facilitate further studies essential for policy makers supporting consistent physical activity and screen time regulations for young children and reliable quality child care indicators. Although the Healthy People 2020 goals have yet to be established, there should be sufficient support for addressing the lack of physical activity guidelines for children birth through five years of age to reduce the rates of childhood obesity.Master of Public Healt

Dietary Intake among Children Attending Childcare Centers: Impact of the New CACFP Meal Guidelines

Through the Healthy, Hunger-Free Kids Act of 2010, USDA (US Department of Agriculture) made the first major changes in the CACFP (Child and Adult Care Food Program) meal and snack menu patterns. Childcare centers that serve low-income families qualify to participate and receive reimbursement for meals and snacks served. The purpose of this study was to assess what changes in children’s dietary behaviors occurred as a result of the new CACFP meal pattern requirements. This study evaluated these changes at childcare centers operating in Houston and San Antonio, Texas, USA, areas enrolled in the CACFP, pre- (Spring 2016) and post-implementation (Fall 2016–Spring 2017) of the new meal patterns. Dietary intake was assessed via observations of children, 3–5 years old, conducted at breakfast, lunch, and snack times. Results showed improvements in adjusted means of several nutrients and food groups consumption, post-implementation of new CACFP meal guidelines compared to baseline, specifically intake of whole grains, milk, and juice. Additional studies are needed to confirm the impact of the revised CACFP meal patterns along with strategies to assist providers in meeting the new standards to increase the access to and intake of items in accordance with the CACFP meal pattern requirements in childcare settings