I can’t believe that my perspective on obesity in America has shifted so dramatically in the last six or so months. I’ve been in the fitness industry for over a decade and have taken countless courses on metabolic diseases, health and wellness. I thought I knew most of what I needed to know…until I realized that I didn’t. One lesser-known fact that I recently learned has changed everything for me. I couldn’t believe it when I found out. It made my jaw hit the ground and simultaneously made me want to cry. This one simple statistic changes the ballgame for all of us. Big time.
While conducting research for a manuscript I’ve been working on for the past year, I came across data about the prevalence of children who are overweight and obese in America. I was curious to read the stats but paused before getting to them. The age range taken into evaluation for childhood obesity is what struck me first. I always wrongly assumed that data on children who are overweight and/or obese referred to school-age children only. Kids get a little wiggle room to grow out of their baby fat, right? But no, the age range that the Centers for Disease Control and Prevention assesses starts at the tender age of TWO! I was floored. For me, this changes everything. Here’s why…
The fact that the age range evaluated for being overweight or obese is from 2-19 years old reflects the fact that obesity starts way before we are irresponsible teenagers guzzling down chips and soda or even school-age children being served controversial, less-nutritious lunches in elementary school cafeterias. Being overweight or obese literally starts when children are adored for having chubby cheeks and pudge. That got me thinking, how can you tell “healthy fat” tots from “unhealthy and overweight” ones? I dug a little deeper and found that the American Academy of Pediatrics (AAP) says that parents shouldn’t worry about the weight of children younger than 2-years old, citing that there is no current and relevant information supporting the notion that children who are heavy as babies are going to be overweight later in life. But just one second…
Today, 30% of American youth are overweight or obese (17% obese, according to National Health and Nutrition Examination Survey 2011-2014 data), with the prevalence of overweight 2 to 3-year olds being 40% higher than it was in 1994! What’s more is that overweight 2-year olds are apparently twice as likely to become obese as an adult. The older a child gets without outgrowing their extra layer of insulation, the greater the risk goes up. Obese 6-year olds have a 50% risk of obesity at 35 years old and obese 10-year olds have up to a 80% risk! Anyone starting to feel a little uncomfortable about these numbers yet? So, going back to the toddlers…how exactly does a 2-year old hit their second birthday and magically go from being considered healthy to overweight? That’s just not fair to the little ones! Obviously, there are things happening in the FIRST TWO YEARS OF LIFE that have the power to set us up as a society for a host of challenges in our childhood onwards into adulthood.
This brings me to my next question: What is happening in the first two years that sets a child up for certain “healthy” vs “unhealthy” habits that are perpetuated throughout their youth? Moreover, what can we do as ADULTS to prevent this? After all, the first two years of life have very little to do with what a child chooses for their nutrition and physical activity and a whole lot to do with what we offer them to eat and how we help them engage (or not) with the world around them. Our attitude towards wellness very directly impacts theirs.
These are my opinions as a health professional so take them for whatever they are worth to you. These are what I see as some of the potential root causes for their unhealthy habits and compromised gut health, and the implications for us as responsible adults.
3 Things that Impact Health in the First 2 Years of Life:
I. Breastfeeding vs. Formula
I’m a big proponent of breastfeeding but I understand that sometimes formula is medically indicated or otherwise chosen by moms who want or need it for convenience. I will spare you my opinions on women’s rights for maternity leave and the necessity to have both time and a place to pump at work, but certainly those factor into maternal nutrition decisions. I digress. When we compare breastmilk and formula side-by-side, we see a couple of differences in potential nutrition and how some babies are fed.
Breastmilk has been fine-tuned by evolution over the course of nearly 200,000 years and its complexities are only just beginning to be understood. Formula, on the other hand, was first developed on a grand scale in the early 1950s and was heavily marketed as an “ideal food” for babies. Yes, formula can adequately nourish babies. That has been proven, otherwise babies being fed formula would fail to gain weight and survive. But, the debate on whether or not it’s “ideal” is certainly a heated one, with proponents on both sides. Here is where I see formula falling short and having the *potential* to impact long-term health (albeit formula is a miracle for babies who have no other options – it was made to save lives – and is in no way, shape or form the only predictor of health outcomes):
Taste changes in milk
Just like unborn babies can taste their mother’s broccoli or potato chips via the amniotic fluid they swallow, nursing babies experience the diverse flavors of mom’s diet via changes in breastmilk flavor. There are breastfeeding advocates out there who would argue that this helps a baby embrace healthy foods later on during the introduction of solids (assuming mommy eats healthy in the first place, of course!).
Ability to digest
Just as there are experts who have brought light to the fact that one-a-day multivitamins are difficult for the body to digest, others have made us aware that formula is also difficult on a baby’s digestive system due to higher caesin content in the milk compared to breastmilk. Although parents get longer breaks between baby’s feedings while his tummy sorts everything out, this lends me to believe that a baby’s system is taxed by its food source and may not absorb all of it. For this same reason, some formula manufacturers continue to attempt to make it with less curd to better simulate digestive processes aligned with breastmilk.
Antibodies and gut health
Antibodies help build up our immune systems and healthy gut bacteria. Breastmilk is full of antibodies that respond and change daily to the specific needs of the baby. Baby gets sick with a cold and mama’s milk provides the medicine for healing. The healthier our gut microbiota, the healthier children (and adults) are in general. Studies are increasingly showing that gut health, inflammation and metabolic diseases (such as obesity) are scientifically linked. This means that protecting our children’s gut health needs to be a fundamental goal of any parent, and breastfeeding is just one way we can do that (and arguably the best way, for children under one-year old).
Bottle-fed babies are sometimes subject to parents and caregivers encouraging them to finish the entire portion of milk in the bottle. Babies have varying metabolisms and milk requirements so while it may be completely appropriate for one baby to guzzle down eight ounces of milk in one slug, this may be overfeeding another child. Milk requirements may also vary day by day. In this way, babies and children are not all that different from adults. We all have different needs and overeating can become a vicious and repetitive cycle thanks to our biological tendency to hoard fat when given the opportunity (I’m telling ya…our bodies still think we are getting chased down by bears). It’s important to practice baby-led bottle feeding.
What this means to us (the adults): If you are a mother or have friends, family or coworkers with a baby, try to be as supportive as possible of the breastfeeding relationship. Don’t give women snarky looks when they are nursing in public or a hard time if they are late to a meeting because they had to finish pumping. For women who choose formula out of necessity or desire, try to encourage them to follow baby’s lead and not push them to finish all of their bottles and food unless the pediatrician has medically advised it. Both breastfeeding and formula-feeding mothers can make enormous strides in their children’s long-term health with the introduction of solids and healthy foods…
II. Introduction of Solids
The introduction of solids is an important time in a baby’s life. The new colors, textures and flavors are all fascinating to babies. While it’s obvious that overfeeding a baby solids can result in too much weight gain, there are some other things to consider that stack up and impact a little one’s health.
Sugary puree packets
Lots of puree packets look lovely – they are organic, produced by trusted brands and packed full of healthy ingredients. What’s not to love?! The challenge with lots of puree packets is that they are loaded with sugar. Baby is already getting about 17 grams of sugar from a cup of breastmilk and, at one-year old, 11 grams of sugar from a cup of cow’s milk. Clearly, sugar is a natural part of a baby’s diet, but as we know from the obesity epidemic taking flight in the 1990s when sugary sodas were having their heyday, too much of the stuff is definitely not good for our health or weight. Even veggie and fruit puree mixes have a ton of it – sometimes as much as 11-13 grams/packet! Even when you have good intentions for baby eating up all of those peas and spinach mixed in, that’s a ton of sugar! The best bet is to try to make your own baby food or choose lower-sugar, store-bought purees.
I will be the first to admit that getting a little one to fall in love with veggies is tricky business, but it’s 100% worth every effort, creative cooking method, and/or baby-friendly spices/seasonings you can muster up. Roughly 38% of American adolescents eat LESS than ONE serving of fruits or vegetables a day. Surely, we can ALL do better than that. We NEED to do better than that, starting right when solids are introduced and kids palates are impressionable. Start early and start healthy!
Yes, it’s difficult to feed extra mouths, but it doesn’t have to be an elaborate, over-the-top ordeal that’s so stressful that we break down and nuke chicken nuggets every night. If we commit ourselves to eating healthy and slowly introducing our children to the same foods, we only have to prepare one meal; the family meal! I’m totally serious – my son eats everything we do and is just a year old. It’s not because he loves salmon, quinoa and veggies more than yogurt, cheese, bread and fruit, Trust me, he would eat all the aforementioned till the cow’s come home, if we let him. He accepts and enjoys healthy foods because we try to offer him the same nutritious foods that we eat (and when we eat them). It makes things far simpler on us and way healthier for him.
What this means to us (the meal providers): Whether or not we feel like we have loads of extra time on our hands to prepare homemade, healthy purees and meals, it’s really not a matter of choice. It’s a necessity for the health of the next generation. If we give up and let nine-month olds dictate an all fruit and bread diet then how are we going to hold our own when those children are five and we are telling them to eat their peas as they protest saying they don’t like the taste? It doesn’t have to be super scary to healthfully feed young children and there are a million blogs, pins on Pinterest and nutrition resources to help make it easy! Find some or personal message me and I will help you navigate it all!
III. Modeling Good Eating
Kids are easily influenced by their surroundings. I’ve heard stories about people with babies who didn’t walk until 18 months when suddenly, on vacation with their older cousins, the child decides to morph into a walking toddler to chase after them. Our healthy choices (or lack thereof) are no different. Kids see their parents eating pizza while they have carrots and they are gonna want the pizza. Plain and simple. Who wouldn’t? Pizza is delicious and shaped like a triangle! Since when did an edible triangle not taste amazing? Watermelon, sandwiches, chips… How we influence the wellness of children is fundamental to solving childhood obesity and its propensity to carry through into adulthood.
Eat healthy foods (duh)
It’s as straightforward as that. Eat healthy foods, in front of a baby and young children, and they will be more apt to eat them too. Think of it as a chance for the whole family to get healthy.
“Snacky” foods typically pack a lot of empty calories. In other words, lots of calories from carbs or sugars with very little return in the way of vitamins, minerals, fiber, healthy fats, etc. They can also cause children (and adults alike) to lose track of what “full” really feels like thanks to zoning out in front of a cartoon while eating fistful after fistful. Mindless snack habits set children (and adults) up for health problems because of the lack of nutrition and risk of overeating (which leaves less of an appetite for healthy meals).
Food as a tool
It’s definitely tempting to shove food in front of kids for any number of reasons, but when food is abused as a tool for getting children to behave better, we begin down a slippery slope that can tie unhealthy behaviors and expectations to treats. And we all know that if you give a kids an inch they take a….yup, mile after mile after mile. Or rather, cookie after ice cream after soda.
What this means to us (the “models” for healthy eating): Modeling healthy eating takes commitment on a regular basis and also talking to kids about why you eat what you do. Even babies can sometimes be influenced to take bites of “yucky” foods when you show excitement and enthusiasm about them – or better yet, are eating the exact same thing in front of them. I understand that it’s unrealistic to expect people to eat healthy foods 24/7. I like to indulge a bit too. So, when you do go off the “healthy-food menu” simply make sure that you keep portions small for children (if you offer any at all) and discuss how certain foods are for unique occasions, and that if we ate them all the time, they would make us tired and give us stomach-aches. Your choice if and how you want to discuss the actual weight gain component.
There is a lot we can do as adults to impact the upcoming generations’ wellness and a lot starts with nutrition. It’s definitely worth noting that activity levels play a tremendous role in the childhood obesity epidemic too, even for babies. Take them out of their car seats and strollers, and let older children run around for fun – it’s the best exercise [playing] that there is! And if you’re feeling just a little bit daunted about setting a healthy example, focus hard on what it will take for YOU to be more healthy and the rest will gradually fall in place. It’s not fair to leave our children and children’s children in a place where they look down at the scale as adults and think “What the heck?! How did this happen? Where did I go wrong?” You will never regret setting a child up for good health because ultimately, it’s an integral part of what makes us happy as humans.
Yours in health and wellness,