Page 11 - Demo

Introduction and Background
The dire consequences of childhood obesity are evident given that children who are obese have a greater risk of:
o High blood pressure and high cholesterol, risk factors for cardiovascular disease.i o Impaired glucose tolerance, insulin resistance, and type 2 diabetes.ii
o Breathing problems, such as sleep apnea, and asthma.iii iv
o Joint problems and musculoskeletal discomfort.v vi
o Fatty liver disease, gallstones, and gastro-esophageal reflux (i.e., heartburn).vii viii
o Psychological stress such as depression, behavioral problems, and issues in school. ix x xi o Low self-esteem and low self-reported quality of life.xii xiii xiv xv
o Impaired social, physical, and emotional functioning.xvi
These health risks continue into adulthood resulting in negative consequences for the individual and their family, as well as economically. Nationally, excess weight in childhood is estimated to result in $3 billion per year in medical costs.xvii
Much of the research conducted with children focuses on the school age years, with less information available on the 0-5 year age group. However, in recent years there has been an increase in understanding that to prevent long-term negative effects of obesity more attention needs to be focused on the earliest years, well before children enter elementary school. The 0-5 year age span is a critical time for developing healthy food preferences and motor skills.xviii Locally 19% of 3- and 4-year-old children in the WIC (Women Infants and Children) program in Los Angeles County were overweight in 2014.xix This data source also shows that Hispanic children have higher obesity rates than children of other ethnic groups (21.1% in 2014).xx
According to the Center for Disease Control and Prevention, one of the many community environmental factors that contributes to childhood obesity is variation in licensing regulations for child care. Given that nearly 11 million children under age 5 in the USxxi and 36.5% of children 0-5 in Los Angeles County (312,000) are in some form of regular child care arrangement,xxii the child care environment may be a key setting in which to provide intervention. In one review of state regulations it was found that most preschoolers may consume half or more of their recommended caloric intake in child care settings.xxiii Additionally, 30.8% of preschoolers watch more than two hours of television per day, increasing their likelihood to become overweight or obese.xxiv As a result, there is a lot of potential for intervention in these early years.
Improving Health in Child Care Settings: 2016 7