Mirror Games at Bordeaux

Any Clues? Preschool Obesity Nudging Down

Preschool obesity rates — in yet another study, published today — are edging down. Are we doing anything to cause this? Or are we just celebrating events we don’t yet fully understand while we do our obesity prevention rituals?

Cynthia Ogden, a CDC epidemiologist and lead author on the study, says “there’s a glimmer of hope.” Published in the Journal of the American Medical Association, the study found that obesity rates have held steady for the last decade overall, but with two exceptions. Tentative progress was seen in reducing rates for preschool children (ages 2-5) from 14% a decade ago to 8% in 2012. The other shift was upward for women over 60, from 32% to 38%.

In both cases, it’s not clear what’s driving the shifts. Of course, no one is claiming credit for driving obesity rates up in women over 60, and none of the experts are offering any theories for why it’s happening.

In the case of preschool rates declining, you can find a range of responses. The scientists are being cautious. David Ludwig of Boston Children’s Hospital calls it “an encouraging preliminary finding.” Experts note that little has been done that would be expected to have an impact on toddlers, except perhaps for changes to the nutritional quality of foods in the Women, Infants, and Children (WIC) program. Also, consumption of drinks with added sugar has dropped measurably.

Policymakers are less shy about claiming victory. The CDC press release trumpeted a 43% drop in preschool obesity. Increased breastfeeding was offered as an explanation — despite a thin evidence base for such a claim. And (no surprise) First Lady Michelle Obama says she is “thrilled at the progress we’ve made over the last few years in obesity rates among our youngest Americans.” Perhaps a bit of puffery is a necessary ingredient for leadership.

But if you want a more evidence-based view of community-based obesity prevention in children, you might get some satisfaction from a new article in Preventive Medicine. In a systematic review and meta-analysis, Luke Wolfenden and colleagues were able to find interventions that produced small, but significant BMI reductions in children.

Research is a good place to go for clues.

Click here and here to read more about the new data from CDC, click here to access the study in JAMA, and click here for the review and meta-analysis of childhood obesity prevention.

Mirror Games at Bordeaux, photograph © Bérenger ZYLA / flickr

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