Early Intervention — More Questions and Problems

Pint-size Zumba offered (one)

One of the problems with early intervention in childhood obesity is that any program a school, day care center, or wellness center might implement, is likely to meet with objections from someone who wants to throw a monkey wrench into it for a pragmatic or ideological reason.

Another problem with early intervention is that nobody seems to know what works. It’s always a tug of war between those who lay the most emphasis on exercise and physical activity, working the calories off; and those who chiefly advocate the improvement of the subject population’s diet, including the taking in of fewer calories. So any program in a day care center or a school ends up being a combination of those two factors, in varying proportions.

Thanks to Michelle Obama’s Let’s Move! campaign and the publicity surrounding the childhood obesity epidemic in general, the world was able to track her attitude, the better to criticize it. In the fall of 2011, when the First Lady addressed a gathering of the Partnership for a Healthier America, her emphasis seemed shift from nutrition, which had previously been the main concern, to physical activity.

Some saw this as natural — “Okay, we’ve talked about that enough, now let’s talk about this for a while.” Others perceived the shift as evidence that Michelle Obama was playing right into the hands of Big Food, and falling prey to their strategy. For The Nation, Bridget Huber wrote:

Food companies like to talk about exercise because it shifts the emphasis from their products and reinforces the industry’s insistence that any food can have a place in a healthy diet. It also shifts the conversation from one about systemic problems — such as food marketing — to individual lifestyle choices (i.e., ‘just exercise more!’). But studies show that exercise, while offering huge health benefits, cannot by itself address obesity or ward off the weight gain that arises from eating junk food.


So day care centers labor under all kinds of rules and best practices relating to nutrition and exercise, while conflicting studies question the efficacy of either or both. No one denies that physical activity is necessary for health, and some can enumerate a dozen or more ways in which this is true. But does it reduce childhood obesity?

The University of Leipzig did a study of preschool-age children in Germany and failed to find a significant relationship between weight and physical activity. Or television. In the age group that was studied, anyway. The researchers found:

Our data demonstrate that preschool-aged children seem to be active enough, as suggested by the scientific communities, independent of weight status and TV consumption. However, studies of older children do indicate associations between weight status and both physical activity and TV consumption. Presumably habits are formed at this early age. It may not be as important then to increase the amount of physical activity in preschool-aged children participate in as it is to foster the awareness of its importance and turn it into a regular part of daily habit especially on the weekends.

In other words, even if the results are not immediately evident, it’s a good idea to train children into high-activity, low-screentime types anyway. The study did find something interesting — that lower socioeconomic status is linked to both increased consumption of media, mainly TV, and to overweight.

Your responses and feedback are welcome!

Source: “Michelle Obama’s Moves,” The Nation, 10/29/12
Source: “Physical Activity in 3-6 Year Old Children Measured by SenseWear Pro…,” NIH.gov, 04/03/13
Image by USAG-Humphreys.

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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