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Study: Head Start Programs May Help Prevent Obesity Among Preschoolers

Obese and overweight preschool-aged children were found to have significantly healthier weight statuses by the time they reached kindergarten age if they participated in Head Start programs, according to a study published online Monday in the journal Pediatrics.

To measure the effect Head Start programs had on obesity and overweight among young children, the study authors drew upon 19,023 children from 12 Head Start programs in Michigan, from February 1, 2005, and August 1, 2013. The programs measured the changes in each child's body mass index from the beginning to the end of two academic years, including the intervening summer.

The study authors then compared the anthropometric measures from those Head Start programs to two comparison groups from a Michigan primary health-care system—5,405 children receiving Medicaid and 19,320 not receiving Medicaid. In total, the authors had a sample of 43,748 children—16.8 percent of whom were obese and 16.6 percent of whom were overweight at the initial observation—and 83,239 anthropometric measures.

Among children who entered Head Start programs as obese, they exhibited a statistically significant decline in BMI over the first academic year, greater than that of children in the Medicaid and non-Medicaid groups. They also exhibited a significant decline in BMI over the following summer, although it was not considered statistically significant compared to the children in the comparison health care groups. Over the second year, children who began the observation period obese exhibited no significant changes in BMI among any group.

The study authors found similar results for children who entered Head Start as overweight. Over the first academic year, they exhibited a significant decline in BMI compared to children in the Medicaid and non-Medicaid group, neither of which showed a significant decline. However, the Head Start children experienced a significant "upward rebound" of BMI over the following summer, which was significantly greater than what happened with children from the health-care groups.

In the second academic year, children who began the observation period as overweight showed no significant change in BMI among the Head Start or Medicaid groups; however, children in the Non-Medicaid group experienced a significant increase in BMI. By the end of the two-year observation period, children who entered Head Start overweight had a significantly lower BMI than those in the Medicaid and non-Medicaid groups, similar to the findings with obese children.

Head Start programs were also found to have a positive effect on children who entered the observation period underweight. Such children experienced an increase in BMI that was greater than the increases from both the Medicaid and non-Medicaid groups during the first academic year. Over the summer, such children in the two health-care groups experienced significant increases in BMI, while those in Head Start exhibited no significant change. In the second academic year, none of the three groups experienced a significant change in BMI. Overall, children who entered the observation period underweight had a BMI that was no different than children in the Medicaid group, but theirs was greater than those in the non-Medicaid group.

"Head Start is associated with improved social and educational outcomes for low-income children. Healthy changes in BMI may be an additional benefit of Head Start participation," the authors concluded.

The authors posited a few theories as to why children in Head Start programs experienced such beneficial changes in BMI, including the federally regulated quality of meals and snacks provided at Head Start, the emphasis on exercise and development of children's gross motor schools, and a prohibition on television viewing. Additionally, the provision of free child care from Head Start could allow families to spend additional money purchasing healthier food, the authors surmise.

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