Childhood obesity has more than doubled in the past 30 years. Elsie Taveras, MD, MPH—chief of the Division of General Academic Pediatrics at MassGeneral Hospital for Children (MGHfC)—studies risk factors and ways to reverse this trend. She is also an Ofer and Shelly Nemirovsky MGH Research Scholar and co-director of the MGHfC Raising Healthy Hearts Clinic, where individualized programs help children with weight-related medical problems improve diet, exercise and sleep habits.
Why is childhood obesity important to investigate?
Obesity and the factors that contribute to obesity are at the root of chronic diseases like diabetes, high blood pressure and cardiovascular disease. Obesity is a major threat to public health and places a significant burden on quality of life, long-term health and healthcare costs.
Has there been progress in reducing obesity?
Our national data show some progress in reduction of obesity prevalence in children ages 2 to 4. This is promising and good news. But obesity remains at historically high levels in children and adults. And the progress isn’t evenly distributed. You don’t see the same progress in certain population subgroups, including African-American children and Hispanic children. We have to more equitably distribute our prevention efforts.
What does a healthy home and neighborhood look like, based on your research?
There are multiple causes of obesity. There are certainly changes that can be made in the home, but it is not just the home that influences the development of obesity. It’s also the communities where people live and the support they receive when following behavior change recommendations. It’s the schools and the quality of foods and beverages in those schools. It’s the parks.
I’ve been doing a lot of work with children under the age of 5. We know that’s a period when children and families spend a lot of time in their homes, but also in the pediatric healthcare system, at day care, using public recreation services and going to supermarkets. We’ve learned that we need coordinated efforts across these areas that support healthy nutrition and physical activity for the family in order to be successful in preventing obesity in early childhood.
Is early childhood the ideal time to do this?
We believe that pregnancy, infancy, and early childhood are critical times for prevention and promoting lifelong healthful routines and behaviors. But that’s not the only time. There needs to be sustained efforts to maintain weight across life.
Conversations with children about weight should be about their long-term health and what a healthier body weight would allow them to do.
How do you recommend parents handle the balance between encouraging children to love their bodies and encouraging healthy choices to lose weight?
I think they are quite independent. No matter what age or what BMI (body mass index) a child is, it’s important that families and healthcare clinicians promote a positive sense of body image and body satisfaction. Body dissatisfaction and an unhealthy body image do not motivate change and can impact a child’s quality of life and wellbeing.
Conversations with children about weight should be about their long-term health and what a healthier body weight would allow them to do. Perhaps a child’s motivation might be to fit into regular rather than plus size clothing, to be better at sports, or to not be teased. We hear from kids that these are important to them and may be ways that parents and clinicians can motivate behavior changes.
What more needs to be done and how can philanthropy help?
An exciting thing that we are doing is to test approaches that cut across the different places where children spend their time to see how to best work together to prevent and reduce obesity. The First 1,000 Days program, for example, is a pilot program following and coaching families from conception through age 2, as we help them establish healthy lifestyles.
We’re also testing a program called Connect for Health, which connects primary care services to youth-serving community organizations like the YMCA. Additional philanthropy would help us expand outreach into other communities and expand use of innovative approaches we know work, including health coaching, technology to engage families in behavior change, and community partnerships to support physical activity.
Is it really possible to get children to eat vegetables?
You can indeed raise a broccoli eater! For some families, that means increasing the vegetables in their own diets, as children often eat what their parents eat and what is available in their homes. It also requires introducing vegetables and other healthy foods and beverages early in life and avoiding sweet and salty foods. In the first year of life infants develop their taste preferences. The way to raise the next generation of healthy eaters is to start early.
For more information about how you can support Dr. Taveras’s work please contact us.