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Few Children Follow Preschool Obesity-Prevention Guidelines, Study Finds

Preschoolers don't eat enough healthy foods or get enough exercise, according to a new study by the Cincinnati Children's Hospital Medical Center.

The study was published online in August in the journal Preventative Medicine Reports.

Play-Playground-hopscotch-Getty-blog.jpg

Researchers studied nearly 400 preschoolers over the course of one 24-hour period at school and at home to find out if the children were meeting what's known as the 5-2-1-0 daily guidelines, which recommend that children eat at least five servings of fruits and vegetables, watch less than two hours of screen time, participate in one hour of physical activity and consume no sugar-sweetened drinks.

Only one child actually met those guidelines.

Less than 1 percent met the physical activity guidelines, while only 17 percent consumed at least five servings of fruit and vegetables. Half of the students refrained from drinking sugar-sweetened beverages, while 81 percent had less than two hours of screen time.

Researchers observed 398 children, who averaged age 4, at various Ohio child-care centers to take note of what the children ate and the amount of their exposure to screen time. They also measured the students' BMI, or body mass index. The children wore monitors that assessed their level of physical activity. Parents documented what the children ate at home and how much time the preschoolers spent watching television or a computer screen. This study was part of the Preschool Eating and Activity Study, which examined the influence of preschool on children's physical activity.

Recommendations for Preschool Teachers, Parents

Dr. Amrik Singh Khalsa is a general academic pediatric fellow at Cincinnati Children's Hospital and the study's lead investigator. He says the findings show that parents and preschool teachers should be doing more to encourage young children to eat a varied diet and exercise more.

"We don't really do a really good job eating fruits and vegetables in general," said Khalsa. "We need to encourage parents and even our child-care centers to offer a variety of fruits and vegetables early on and try to serve not only what kids like but new and different [foods] that children can try."

And, while children in the study fared much better when it came to limiting screen time, Khalsa says there is still room for improvement.

"A lot of kids got about an hour of screen time at home," said Khalsa. "If we encourage our families to reduce the amount of screen time and allow for more free play, that can help us in two of the recommendations. That includes not only reducing screen time but also increasing the physical activity measure."

The study mentions that the childhood obesity problem continues to get worse. Currently, 9 percent of preschool-aged children are considered to be obese, and these children are more likely to become obese adults.

Despite only one child in the study meeting the obesity-prevention guidelines, only 26 percent had a BMI which indicated they were overweight.

Khalsa points to the fact that there are several factors which determine whether someone will be overweight and says it's still important to determine if children are meeting these guidelines because they often predict future behavior.

"We need to think about not only overweight but risk of overweight," said Khalsa.  "Eating habits, lifestyle habits are consistent over time. Kids who early on have certain patterns in fruit and vegetable intake tend to have similar patterns as they grow up."

He also stresses that this study looked at these children over a 24-hour period and only a longitudinal study would be able to determine the impact of not meeting these recommendations consistently. But he adds that all four recommendations are associated with positive health outcomes in children and adults.

Khalsa also says that it will take a strong commitment at the personal, community and national levels to make sure that all children follow these guidelines.

The 5-2-1-0 guidelines were initially developed by the Maine Youth Overweight Collaborative obesity prevention program and have been used in several national public health campaigns.

Photo: In this stock photo, a young child plays hopscotch. (Getty)

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