Preschool Obesity Declines: Your Role in Curbing the Epidemic

by deborah ziebarth RN, MSN, PhD Candidate.

Photo courtesy of  Flickr Creative Commons.

Photo courtesy of Flickr Creative Commons.

Childhood obesity and the accompanying health complications are a nasty reality in the United States, but recent studies suggest a silver lining. There is good news for America’s children age 2–4 years on the obesity front. Data suggest that the epidemic declined among preschool children between 2003 and 2010, when rates were at 2.22% to 2.07%, respectively. Previously, the prevalence of obesity had increased from 1998 through 2003 from 1.75% to 2.22%, with the greatest average annual increases being among non-Hispanic whites. While those numbers may not seem significant, the study’s population included 27.5 million children, which adds up to more than 500,000 kids. These data were reported to the Centers for Disease Control and Prevention (CDC) Pediatric Nutrition Surveillance System from 1998–2010.1

This decline in the prevalence of obesity in American children indicates that we are heading in the right direction. Obesity poses serious risks such as cardiovascular disease, increased healthcare costs, and premature death. Children who are obese or extremely obese during early childhood are also likely to be obese during middle or late childhood and adulthood. And as if those threats aren’t enough, just think about all the playground taunting and teasing that obesity exposes young and impressionable children to.

Between the ages of 2 and 5, the average child grows about 2½ inches taller each year and gains 4 to 5 pounds each year. Growth charts are a good way to monitor growth and health. The preschooler's growth over time is an important sign of good health and nutrition. As part of a routine doctor’s visit, weight and other measurements will plot the child's information on a growth chart. Over time, the curve of the growth chart will show growth patterns and whether height and weight growth are increasing at normal rates. The doctor will monitor the growth chart to be sure the child continues to follow the same curve over time and to check that the growth pattern does not unexpectedly change. You can download a preschool Body Mass Index or a growth chart at

Heights and weights differ depending on:

  • Family History: Tall parents tend to have tall children. Short parents tend to have short children.
  • Sex: Preschool boys tend to be taller than preschool girls. Boys and girls tend to have similar weights until puberty.
  • Nutrition: Healthy food choices are necessary for healthy growth. Children who are better nourished tend to be taller.
  • Sleep Patterns: Preschoolers need 11–14 hours of sleep a day, including naps and nighttime sleep. Children who get more rest are generally taller.


Although we are making strides in eradicating childhood obesity, there is still more that can be done. Nannies have a special role in the health and development of the children in their care and can help in reducing obesity risks of preschoolers in a number of ways, such as by maintaining daily food plans. These plans show what and how much your charge should eat to meet his or her individual caloric and nutritional needs. You can download a sample daily food plan at Daily food plans are based on average needs by age and activity level. A preschooler’s food needs also depend on how fast he or she is growing. Use the plan as a general guide to help you feed your preschool charge.

  • Offer different foods from day to day. Encourage the child to choose from a variety of foods, like strawberries one day and mangoes the next. Limit intake of junk foods, like ice cream and candy.
  • Serve foods in small portions at scheduled meals and snacks.
  • Choose healthy snacks for your preschool charge, like veggie sticks and a light dip.
  • Beverages count too. Make smart beverage choices. Avoid sugary soft drinks and juices.

Do not be concerned if the preschooler does not eat the exact amounts suggested by the plan. Each child's needs may differ from the average, and appetites can vary from day to day. Try to balance the amounts over a few days or a week. Check this table to find the right calorie level for your charge and then choose healthy meals and snacks for that calorie level.


Reproduced from Table. Meal and Snack Patterns and Ideas.


1. Trends in the Prevalence of Extreme Obesity Among US Preschool-Aged Children Living in Low-Income Families, 1998-2010. JAMA. 2012; 308 (24): 2563-2565.