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Obesity in Preschoolers: Behavioral Correlates and Directions for Treatment
Article first published online: 6 SEP 2012
DOI: 10.1038/oby.2011.201
2012 North American Association for the Study of Obesity (NAASO)
1930-739X/asset/cover.gif?v=1&s=37fbf24431bb1572c44ca9228baa670568e5066d "Obesity")
Additional Information
How to Cite
Kuhl, E. S., Clifford, L. M. and Stark, L. J. (2012), Obesity in Preschoolers: Behavioral Correlates and Directions for Treatment. Obesity, 20: 3–29. doi: 10.1038/oby.2011.201
Publication History
- Issue published online: 6 SEP 2012
- Article first published online: 6 SEP 2012
- Received 3 November 2010; accepted 31 May 2011
References
- 1, , , . Prevalence and trends in overweight among US children and adolescents, 1999–2000. JAMA 2002;288:1728–1732.
- 2, , et al. Prevalence of overweight and obesity in the United States, 1999–2004. JAMA 2006;295:1549–1555.
- 3, , , , . Prevalence and trends of severe obesity among US children and adolescents. Acad Pediatr 2009;9:322–329.
- 4, , , . Predicting overweight and obesity in adulthood from body mass index values in childhood and adolescence. Am J Clin Nutr 2002;76:653–658.
- 5, , et al. Body fatness and risk for elevated blood pressure, total cholesterol, and serum lipoprotein ratios in children and adolescents. Am J Public Health 1992;82:358–363.
- 6, , , . Blood pressure is associated with body mass index in both normal and obese children. Hypertension 2000;36:165–170.
- 7, . Stigma, obesity, and the health of the nation's children. Psychol Bull 2007;133:557–580.
- 8, , . Childhood overweight and academic performance: national study of kindergartners and first-graders. Obes Res 2004;12:58–68.
- 9, , et al. The multiphase optimization strategy for engineering effective tobacco use interventions. Ann Behav Med 2011;41:208–226.
- 10; Expert Committee. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics 2007;120 Suppl 4:S164–S192.
- 11, , , . Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000;320:1240–1243.
- 12, , . Changes in diet quality of American preschoolers between 1977 and 1998. Am J Public Health 2004;94:1525–1530.
- 13, , . Diet and behavior in at-risk children: evaluation of an early intervention program. Public Health Nurs 2004;21:122–127.
- 14, , et al. Overweight among low-income preschool children associated with the consumption of sweet drinks: Missouri, 1999–2002. Pediatrics 2005;115:e223–e229.
- 15
- 16, , , . Most Americans eat much less than recommended amounts of fruits and vegetables. J Am Diet Assoc 2006;106:1371–1379.
- 17, , et al. Recommendations for treatment of child and adolescent overweight and obesity. Pediatrics 2007;120 Suppl 4:S254–S288.
- 18, , . Correlates of fruit and vegetable intakes in US children. J Am Diet Assoc 2009;109:474–478.
- 19, . Dietary sources of energy, solid fats, and added sugars among children and adolescents in the United States. J Am Diet Assoc 2010;110:1477–1484.
- 20, , . The increasing prevalence of snacking among US children from 1977 to 1996. J Pediatr 2001;138:493–498.
- 21, , . Diet, activity, and overweight among preschool-age children enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Prev Chronic Dis 2006;3:A49.
- 22, , . Increasing caloric contribution from sugar-sweetened beverages and 100% fruit juices among US children and adolescents, 1988–2004. Pediatrics 2008;121:e1604–e1614.
- 23
- 24, , , , . Sugar-added beverages consumption among kindergarten children of Crete: effects on nutritional status and risk of obesity. BMC Public Health 2008;8:279.
- 25, . Changes in beverage intake between 1977 and 2001. Am J Prev Med 2004;27:205–210.
- 26, , , , . Beverage intake of girls at age 5 y predicts adiposity and weight status in childhood and adolescence. Am J Clin Nutr 2009;90:935–942.
- 27, , et al. Risk factors of obesity in a five year old population. Parental versus environmental factors. Int J Obes Relat Metab Disord 1992;16:721–729.
- 28
- 29
- 30. Dimensions of preschool children's food preferences. J Nutr Educ 1979;11:77–80.
- 31. Preschool children's food preferences and consumption patterns. J Nutr Educ 1979;11:189–192.
- 32. Development of taste perception in humans: sensitivity and preference throughout the life span. Psychol Bull 1981;90:43–73.
- 33, , , . Children's food preferences: a longitudinal analysis. J Am Diet Assoc 2002;102:1638–1647.
- 34, , , , . Black children with high preferences for fruits and vegetables are at less risk of being at risk of overweight or overweight. J Am Diet Assoc 2008;108:1912–1915.
- 35, , , . Effects of instrumental consumption on children's food preference. Appetite 1982;3:125–134.
- 36, . I don't like it; I never tried it: effects of exposure on two-year-old children's food preferences. Appetite 1982;3:353–360.
- 37, , et al. Increasing children's acceptance of vegetables; a randomized trial of parent-led exposure. Appetite 2003;40:155–162.
- 38. Effects of peer models' food choice and eating behaviors on preschoolers' food preferences. Child Dev 1980;51:489–496.
- 39, , , . Prevalence of picky eaters among infants and toddlers and their caregivers' decisions about offering a new food. J Am Diet Assoc 2004;104:s57–s64.
- 40, , , . How pediatricians can improve diet and activity for overweight preschoolers: a qualitative study of parental attitudes. Acad Pediatr 2009;9:172–178.
- 41, , , . The role of parental control practices in explaining children's diet and BMI. Appetite 2008;50:252–259.
- 42, , , . Parental influences on young girls' fruit and vegetable, micronutrient, and fat intakes. J Am Diet Assoc 2002;102:58–64.
- 43, , , . ‘Finish your soup': counterproductive effects of pressuring children to eat on intake and affect. Appetite 2006;46:318–323.
- 44, , . Family food environment and dietary behaviors likely to promote fatness in 5–6 year-old children. Int J Obes (Lond) 2006;30:1272–1280.
- 45, , , . The effects of parental influences on children's food intake, physical activity, and weight status. Int J Eat Disord 1986;5:335–346.
- 46, , et al. Maternal feeding practices and beliefs and their relationships to overweight in early childhood. J Dev Behav Pediatr 2001;22:391–408.
- 47, . Restricting access to foods and children's eating. Appetite 1999;32:405–419.
- 48, , . Learning to overeat: maternal use of restrictive feeding practices promotes girls' eating in the absence of hunger. Am J Clin Nutr 2003;78:215–220.
- 49, , . Expanding the concept of parental control: a role for overt and covert control in children's snacking behaviour? Appetite 2006;47:100–106.
- 50, , et al. Measuring feeding in low-income African-American and Hispanic parents. Appetite 2006;46:215–223.
- 51, , , , . Revisiting a neglected construct: parenting styles in a child-feeding context. Appetite 2005;44:83–92.
- 52, , , . The benefits of authoritative feeding style: caregiver feeding styles and children's food consumption patterns. Appetite 2005;44:243–249.
- 53, , et al. Associations among parental feeding styles and children's food intake in families with limited incomes. Int J Behav Nutr Phys Act 2009;6:55.
- 54, , . Predictors of maternal child-feeding style: maternal and child characteristics. Appetite 2001;37:231–243.
- 55, , , , . Maternal feeding strategies, child eating behaviors, and child BMI in low-income African-American preschoolers. Obesity (Silver Spring) 2006;14:2026–2033.
- 56, , et al. Parental feeding attitudes and styles and child body mass index: prospective analysis of a gene-environment interaction. Pediatrics 2004;114:e429–e436.
- 57, . Eating in the absence of hunger and overweight in girls from 5 to 7 y of age. Am J Clin Nutr 2002;76:226–231.
- 58, . Maternal weight status modulates the effects of restriction on daughters' eating and weight. Int J Obes (Lond) 2005;29:942–949.
- 59, , , , . Indulgent feeding style and children's weight status in preschool. J Dev Behav Pediatr 2008;29:403–410.
- 60, , , , . Parenting styles and overweight status in first grade. Pediatrics 2006;117:2047–2054.
- 61, , et al. Why don't low-income mothers worry about their preschoolers being overweight? Pediatrics 2001;107:1138–1146.
- 62, . Mothers' child-feeding practices influence daughters' eating and weight. Am J Clin Nutr 2000;71:1054–1061.
- 63, , , , . Maternal perceptions of overweight preschool children. Pediatrics 2000;106:1380–1386.
- 64, . Does parenting affect children's eating and weight status? Int J Behav Nutr Phys Act 2008;5:15.
- 65, , , . Risk factors for childhood overweight: a prospective study from birth to 9.5 years. J Pediatr 2004;145:20–25.
- 66, , . Dietary recommendations to prevent and manage chronic pediatric health conditions: adherence, intervention, and future directions. J Dev Behav Pediatr 2001;22:130–143.
- 67. Eating competence: definition and evidence for the Satter Eating Competence model. J Nutr Educ Behav 2007;39:S142–S153.
- 68, , , , . Compliance with physical activity guidelines in preschool children. J Sports Sci 2010;28:603–608.
- 69, , , , . Adherence to physical activity and electronic media guidelines in Australian pre-school children. J Paediatr Child Health 2009;45:5–8.
- 70, , et al. Fatness, physical activity, and television viewing in children during the adiposity rebound period: the Iowa Bone Development Study. Prev Med 2002;35:563–571.
- 71, , , . The association between an objective measure of physical activity and weight status in preschoolers. Obesity (Silver Spring) 2007;15:686–694.
- 72, . Habitual physical activity and physical activity intensity: their relation to body composition in 5.0-10.5-y-old children. Eur J Clin Nutr 2004;58:285–291.
- 73, , . Measurement of physical activity in preschool children. Med Sci Sports Exerc 2010;42:508–512.
- 74, , , , . Preschool children and physical activity: a review of correlates. Am J Prev Med 2008;34:435–441.
- 75, , , . What do parents and preschool staff tell us about young children's physical activity: a qualitative study. Int J Behav Nutr Phys Act 2008;5:66.
- 76, , , , . Preschoolers' physical activity behaviours: parents' perspectives. Can J Public Health 2005;96:299–303.
- 77, , , , . Physical activity in overweight and nonoverweight preschool children. Int J Obes Relat Metab Disord 2003;27:834–839.
- 78, , et al. Objectively measured physical activity and body mass index in preschool children. Int J Pediatr 2010;2010.
- 79, , , . A longitudinal analysis of accelerated weight gain in preschool children. Pediatrics 1995;95:126–130.
- 80, , et al. Does early physical activity predict body fat change throughout childhood? Prev Med 2003;37:10–17.
- 81, , . Developing a Treatment Program for Obesity in Preschool Age Children: Preliminary Data. Child Health Care 2010;39:34.
- 82, , et al. A pilot randomized controlled trial of a clinic and home-based behavioral intervention to decrease obesity in preschoolers. Obesity (Silver Spring) 2011;19:134–141.
- 83Xanthopoulos M, Hart C, Jelalian E. Developmental Considerations in the Prevention of Pediatric Obesity. In: Jelalian E, Steele RG (eds). Handbook of Childhood and Adolescent Obesity: Issues in Clinical Child Psychology. Springer: New York, NY, 2008, pp 183–200.
- 84, , et al. Feasibility and benefits of a parent-focused preschool child obesity intervention. Am J Public Health 2004;94:1490–1495.
- 85, , et al. Effects of a three-year intervention on children's physical activity from age 4 to 7. Pediatr Exerc Sci 2004;16:167–180.
- 86, , , , . Assessing children's physical activity in their homes: the observational system for recording physical activity in children-home. J Appl Behav Anal 2009;42:1–16.
- 87, , et al. Social and environmental factors associated with preschoolers' nonsedentary physical activity. Child Dev 2009;80:45–58.
- 88, , et al. The childcare environment and children's physical activity. Am J Prev Med 2008;34:23–29.
- 89, , , , . Directly observed physical activity levels in preschool children. J Sch Health 2008;78:438–444.
- 90, . Prevalence, correlates, and trajectory of television viewing among infants and toddlers. Pediatrics 2002;109:634–642.
- 91, , et al. Digital childhood: electronic media and technology use among infants, toddlers, and preschoolers. Pediatrics 2007;119:e1006–e1015.
- 92, , , , . Television exposure and overweight risk in preschoolers. Arch Pediatr Adolesc Med 2006;160:417–422.
- 93, . Preschool-aged children's television viewing in child care settings. Pediatrics 2009;124:1627–1632.
- 94, , , . Association between television viewing and poor diet quality in young children. Int J Pediatr Obes 2008;3:168–176.
- 95, , , , . Screen-viewing behaviors among preschoolers parents' perceptions. Am J Prev Med 2005;29:120–125.
- 96, , . Parental confidence in making overweight-related behavior changes. Pediatrics 2009;124:151–158.
- 97, , . Television viewing and television in bedroom associated with overweight risk among low-income preschool children. Pediatrics 2002;109:1028–1035.
- 98
- 99, , , . Statewide intervention to reduce television viewing in WIC clients and staff. Am J Health Promot 2005;19:418–421.
- 100, , , . An intervention to reduce television viewing by preschool children. Arch Pediatr Adolesc Med 2004;158:170–176.
- 101, , . Is sleep duration associated with childhood obesity? A systematic review and meta-analysis. Obesity (Silver Spring) 2008;16:265–274.
- 102, , , . Is obesity associated with poor sleep quality in adolescents? Am J Hum Biol 2002;14:762–768.
- 103, , , , . Reduced risk for overweight and obesity in 5- and 6-y-old children by duration of sleep-a cross-sectional study. Int J Obes Relat Metab Disord 2002;26:710–716.
- 104, , et al.; Avon Longitudinal Study of Parents and Children Study Team. Early life risk factors for obesity in childhood: cohort study. BMJ 2005;330:1357.
- 105, , . Sleep and the body mass index and overweight status of children and adolescents. Child Dev 2007;78:309–323.
- 106, , et al. Sleep duration and hyperglycemia among obese and nonobese children aged 3 to 6 years. Arch Pediatr Adolesc Med 2010;164:46–52.
- 107, , et al. Association between inadequate sleep and insulin resistance in obese children. J Pediatr 2007;150:364–369.
- 108, , , . Brief communication: Sleep curtailment in healthy young men is associated with decreased leptin levels, elevated ghrelin levels, and increased hunger and appetite. Ann Intern Med 2004;141:846–850.
- 109, , , , . Fasting leptin and appetite responses induced by a 4-day 65%-energy-restricted diet. Int J Obes (Lond) 2006;30:122–128.
- 110, , . Brief report: a “storybook” ending to children's bedtime problems-the use of a rewarding social story to reduce bedtime resistance and frequent night waking. J Pediatr Psychol 2004;29:389–396.
- 111, . A faded bedtime with response cost protocol for treatment of multiple sleep problems in children. J Appl Behav Anal 1991;24:129–140.
- 112. Cognitive-behavioral treatment for childhood sleep disorders. Clin Psychol Rev 2005;25:612–628.
- 113, , , . Family-based behavioral weight control in obese young children. J Am Diet Assoc 1986;86:481–484.
- 114, . A Clinical Guide to Pediatric Sleep: Diagnosis and Management of Sleep Problems. Lippincott Williams & Wilkins: Philadelphia, 2003.
- 115, , et al. Reducing obesity in early childhood: results from Romp & Chomp, an Australian community-wide intervention program. Am J Clin Nutr 2010;91:831–840.
- 116, , et al. Two-year follow-up results for Hip-Hop to Health Jr.: a randomized controlled trial for overweight prevention in preschool minority children. J Pediatr 2005;146:618–625.
- 117, , et al. Hip-Hop to Health Jr. for Latino preschool children. Obesity (Silver Spring) 2006;14:1616–1625.
- 118, . Obesity prevention in preschool native-american children: a pilot study using home visiting. Obes Res 2003;11:606–611.
- 119, , et al. Prevention of overweight in preschool children: results of kindergarten-based interventions. Int J Obes (Lond) 2009;33:1075–1083.
- 120, , , . Effects of a controlled trial of a school-based exercise program on the obesity indexes of preschool children. Am J Clin Nutr 1998;68:1006–1011.
- 121, , et al. Physical activity to prevent obesity in young children: cluster randomised controlled trial. BMJ 2006;333:1041.
- 122, , et al. “Healthy-start”: outcome of an intervention to promote a heart healthy diet in preschool children. J Am Coll Nutr 2002;21:62–71.
- 123, , et al. Healthy Start: a comprehensive health education program for preschool children. Prev Med 1998;27:216–223.
- 124, , , . Cardiovascular risk reduction in preschool children: the “Healthy Start” project. J Am Coll Nutr 2004;23:117–123.
- 125, , . Feasibility and efficacy of a “move and learn” physical activity curriculum in preschool children. J Phys Act Health 2008;5:88–103.
- 126, . Childhood diet, overweight, and CVD risk factors: the Healthy Start project. Prev Cardiol 2008;11:11–20.Direct Link:
- 127, , . Comparison of methods to evaluate changes in relative body mass index in pediatric weight control. Am J Hum Biol 2007;19:487–494.
- 128
- 129
- 130, , , . Treatment of child and adolescent obesity: reports from pediatricians, pediatric nurse practitioners, and registered dietitians. Pediatrics 2002;110:229–235.
- 131, , , , . Parental perceptions of overweight in 3–5 y olds. Int J Obes (Lond) 2005;29:353–355.
- 132, , , . Childhood obesity: do parents recognize this health risk? Obes Res 2003;11:1362–1368.
- 133, , et al. Perceptions of health status and play activities in parents of overweight Hispanic toddlers and preschoolers. Fam Community Health 2005;28:130–141.
- 134, , et al. Parental recognition of overweight in school-age children. Obesity (Silver Spring) 2008;16:630–636.
- 135, , . Rapid weight gain during the first year of life predicts obesity in 2–3 year olds from a low-income, minority population. J Community Health 2009;34:370–375.