It only takes a stroll around a local mall to notice that people are getting bigger. Not only are 60% of American adults overweight, toddlers are now counted among the groups with increased rates of obesity leading to potentially damaging health complications. Since the 1960s the prevalence of childhood obesity has more than doubled. Ten percent of preschoolers are now considered overweight, compared with less than 5% in 1971. Obesity is now considered the nation's number one public health problem.

Why are we so concerned about the growing numbers of overweight Americans? Health complications linked to obesity include Type 2 diabetes, hypertension (high blood pressure), high blood cholesterol and triglyceride levels, sleep apnea, orthopedic problems, asthma complications and lower self esteem. The costs to society to treat these complications are overwhelming and will have an enormous impact on an already stressed health care system.

What are some of the factors contributing to this problem? They include an increasing number of working families eating out on a regular basis, the tremendous growth in portion sizes of food available, soaring rates of soft drink consumption in the U.S., the vast amount of money spent by corporations to advertise high calorie/low nutrient foods to young children, the ready availability of snack and convenience foods high in fat and calories, and the decreasing rates of physical activity among people of all ages.

How do we turn the tide of social forces contributing to increased weight gain, especially for our children? One way is to focus on the prevention of obesity among young children. We need to:

• Learn more about infant cues that indicate hunger and fullness and how to appropriately respond to these cues;
• Provide better support to mothers who breastfeed their infants and find ways to keep babies breastfeeding while in child care;
• Teach preschoolers to know the difference between physiological hunger and the desire to eat because food is available (and tastes good!);
• Offer nutritious foods that taste good in child care programs and encourage family style meal service that trains children to take a portion appropriate for their appetite and honors a child's ability to stop eating when full;
• Plan menus that follow the Dietary Guidelines for Americans and include a variety of fruits and vegetables instead of french fries and tater tots;
• Stop using food as a reward or comfort item and coercing children into cleaning their plates;
• Find ways to build physical activity into the curriculum for very young children and to encourage staff working with children to model physically active behaviors;
• Inform parents of the need to limit television viewing, computer use and other sedentary behaviors among children.

These are some of the goals the Child Care Program hopes to achieve through a grant we've received to provide training on physical activity and nutritious menu planning to preschool and school age child care staff in King County. The first of these trainings will be Oct. 11 (preschool) and Nov. 15 (school age). Please see the enclosed conference flyer, Fuel for Play the Healthy Way. We'll offer additional training and assistance to child care providers in Spring 2004 We can work together to offer children a healthy start in life and hopefully find ways to turn back the rising tide of childhood obesity in our region.