By Juan Miguel Pedraza

In a series of interviews with parents of preschool children, Nuananong “Lek” Seal, an assistant professor in the College of Nursing’s Department of Family and Community Nursing, hears answers that point to novel ways of dealing with early childhood obesity.

"As a pediatric nurse, I am deeply interested in addressing weight issues in preschool children,” said Seal, who is from Thailand.

“My research shows that overweight preschoolers tend to be in overweight families,” said Seal, whose related research interests include families and women’s health, environmental health, and health risk behaviors in children and youth.

“My goal was to develop ways to encourage young children in lifelong good health practices,” she continued, noting that childhood obesity rates are rising fast.

According to the Centers for Disease Control and Prevention (CDC), the obesity rates doubled in just two decades for children ages 6 to 11. About one-third of U.S. children, or 25 million, are overweight or at risk of becoming overweight.

More troubling, Seal notes, is what this signals: “Childhood obesity puts kids on a path to multiple health problems such as diabetes, high blood pressure, and cardiovascular disease.”

Fixing this problem isn’t as simple as 1-2-3, Seal said.

“There are many cultural and environmental factors that lead to early childhood weight problems,” she explained. “In interviewing families with young children in focus-group settings, I discovered that educating young children about healthy eating and exercise starts with the parents.”

Genetics, despite popular assumptions, is not the answer.

“Shared genes can play a role in whether a person tends to put on pounds more easily,” Seal said. “But the research evidence, mine included, points to cultural and family environments as playing a significant role in whether a young child becomes obese.”

It boils down to basic physics: “Whether you’re 6 years old or 60, obesity means there’s an imbalance between energy intake and energy expenditure. Even in young children, it’s about maintaining a balance between what you eat and what you do,” Seal observed.

Then there are the economics, which complicate the arithmetic of calories taken in versus calories burned. In many families with overweight little children, Seal’s research shows, food consumption tends to focus on high fat-density foods

that are high in calories, mostly because they’re cheaper. Call it the “coupon effect.”

Seal says the parents she interviewed complained that “eating healthy,” costs more. Next time you’re grocery shopping, try pricing a big box of chicken nuggets or a 10-pizza deal against a couple of bunches of broccoli and a bag of fresh fruit. The first two carry coupons; the latter, rarely.

"Parents often choose foods with coupons, not necessarily the healthy choices,” noted Seal.

Add the “clean plate” culture to the economic equation, and the weight effects add up.

“Parents insist that nothing be left on the plate,” Seal observed. ”That behavior overrides a child’s natural feelings when they’ve had enough to eat, and that can induce obesity.” And as for activity, the culture of worry about winter weather and personal safety forces children to spend a lot of time playing indoors, she added.

Seal’s research suggests that many parents of overweight or obese children don’t share the concerns of their clinicians.

“They think that because their kids are young, there’s time for them to get in shape later,” she noted. “But the evidence shows that preschoolers who are overweight tend to become overweight adolescents, and overweight adolescents are a lot more likely to become obese adults.”

Though there’s a lot more to be learned about obesity in young children and their families, Seal said her research points to encouraging suggestions.

“I believe that one of the most effective ways to help these children is to educate the parents,” she stated. “I think it’s important to help parents form good ideas and good practice about what’s good for their children’s health in terms of what they eat and how much they exercise.”

“What I’m thinking about, ultimately, is how to prevent obesity, and I think one of the best ways to do that is to look at changing habits in preschool children,” said Seal. “And the best way to do that is to focus on families.”