AAP Releases New Recommendations for Preventing Childhood Obesity

A week after JAMA released a report that found more than two-thirds of Americans age 25 years and older are overweight or obese, the American Academy of Pediatrics (AAP) presented updated guidelines on preventing childhood obesity and recommendations for parents to help their children maintain a healthy weight.

The AAP encourages pediatricians begin obesity prevention with expectant mothers and recommend mothers breastfeed exclusively for the first 6 months and then combine breastfeeding with complementary foods until the child is a year old.

“I think the good that can be done in terms of prevention and early intervention especially down to the young ages … is tremendous compared to the degree of difficulty everyone has when the family, the child and the practitioner are trying hard to work on a child who already has developed obesity,” AAP President Sandra G. Hassink, MD, FAAP, who co-authored the report, said in a statement.

The AAP recommends a diet that is rich in vegetables, fruits, whole grains, low-fat dairy, lean meats, lean fishes, and legumes, and includes drinking water and low-fat milk—for children who are at least 1 year old, a small amount of 100% fruit juice is allowed. Diets should leave out sweetened beverages, fried foods, fatty meats, baked goods, and sweets.

In addition to food and drink recommendations, AAP discourages time in front of TV and other screens for children under the age of 2, and for older children recommends limiting time to 2 hours per day. Children should meet the national guidelines of 60 minutes of moderate to vigorous physical activity each day.

To identify children at risk of developing obesity, weight-for-age and weight-for-length should be monitored for children from birth to 23 months using the World Health Organization normative growth charts. After that, body mass index (BMI) changes should be monitored and interventions can be implemented before a child approaches the 85th or 95th percentiles. However, only 46% of pediatricians routinely calculate and plot BMI, according to AAP.

“I think having a pediatrician sending a really positive message that families can make changes, that those changes can improve health and can help to prevent or reduce obesity is really powerful,” said Stephen R. Daniels, MD, PhD, FAAP, chair of the Committee on Nutrition and co-author of the report.