1 Making the Healthy Choice the Easy Choice Policies for Reducing Screen Time and Increasing Physical Activity in Early Childhood Settings.

2 Making the Healthy Choice the Easy Choice By the end of this session you will be able to: List causes of childhood overweight List causes of childhood overweight Describe policies to prevent overweight in child care Describe policies to prevent overweight in child care Plan to encourage physical activity and reduce TV and other screen time activities in your child care setting. Plan to encourage physical activity and reduce TV and other screen time activities in your child care setting.

3 Childhood Overweight: Growing Problem?

4 Obesity Trends* Among U.S. Adults BRFSS, 1991, 1995 and 2000 (*BMI  30, or ~ 30 lbs overweight for 5’4” woman) Source: Mokdad A H, et al. J Am Med Assoc 1999;282:16, 2001;286:10. No Data 20%

5 Weight Trends

6 Why is this happening?

7 140 calories 3-inch diameter Calorie Difference: 210 calories 350 calories 6-inch diameter BAGEL 20 Years Ago Today National Heart, Lung, and Blood InstituteObesity Education Initiative

8 20 Years AgoToday 270 calories 5 cups POPCORN 630 calories 11 cups Calorie Difference: 360 calories National Heart, Lung, and Blood InstituteObesity Education Initiative

9 Calorie Difference: 257 calories 590 calories CHEESEBURGER 20 Years Ago Today 333 calories National Heart, Lung, and Blood InstituteObesity Education Initiative

10 Eating Patterns More meals away from home More meals away from home Larger portion sizes Larger portion sizes More sweetened beverages More sweetened beverages Less milk Less milk Skipping Breakfast Skipping Breakfast

11 Less Time Being Physically Active More TV and video time More TV and video time Less recess/PE in schools Less recess/PE in schools Safety issues in neighborhoods Safety issues in neighborhoods

12 Physical Activity in Preschools Pate RR, et al. Physical activity among children attending preschools. Pediatrics, 2004 Pate RR, et al. Physical activity among children attending preschools. Pediatrics, 2004

13 What the study tells us… Children are not meeting the goal for a total of 2 hours of activity each day Children are not meeting the goal for a total of 2 hours of activity each day The preschool a child attended made a huge difference in the child’s activity level The preschool a child attended made a huge difference in the child’s activity level Preschool policies mattered more than any other factor Preschool policies mattered more than any other factor

14 The case against television….

15 How much television should children watch? The American Academy of Pediatrics (AAP) recommendations for children and TV watching: Children under 2 should watch NO TV Children under 2 should watch NO TV Children 2 and older should watch less than two hours a day Children 2 and older should watch less than two hours a day

16 What’s the reality? The average child watches 20 hours of television per week The average child watches 20 hours of television per week Children in America currently spend more time watching TV than anything else other than sleeping Children in America currently spend more time watching TV than anything else other than sleeping 1/3 of preschoolers live in homes where TV is on “almost all” or “most” of the time 1/3 of preschoolers live in homes where TV is on “almost all” or “most” of the time 31 % of preschoolers have a TV in their bedroom. 31 % of preschoolers have a TV in their bedroom.

17 TV & Overweight in Children TV may replace physical activity

18 Percentage of Children with TV in Bedroom by Child BMI Group M-H Chi-square= 12.9 (df=1); p< Bassett-NYS WIC Partnership BMI Percentile

19 Doing the math…. MET = Metabolic equivalents of task MET = Metabolic equivalents of task Energy used for sitting quietly = (1 kcal/kg/h) or I MET Energy used for sitting quietly = (1 kcal/kg/h) or I MET Harrell JS et al. Med Sci Sports and Exercise, Energy Cost of Pysical Activities in Children and Adolescents. Harrell JS et al. Med Sci Sports and Exercise, Energy Cost of Pysical Activities in Children and Adolescents.

20 Energy Cost of Activities Children 8-12 ActivityMETs TV watching 1.0 Homework1.3 Video game sitting 1.5 Board game 1.5 Video game standing 2.3 Walking 2.5 mph 3.0 Harrell JS et al

21 TV & Overweight in Children TV may increase snacking on foods high in fat and sugar TV may increase snacking on foods high in fat and sugar Families buy what is advertised on TV Families buy what is advertised on TV

22 The Power of “Branding” 3-6 year olds are able to identify brand logos for all types of products 3-6 year olds are able to identify brand logos for all types of products Being able to identify brand logos increases with TV watching Being able to identify brand logos increases with TV watching Kaiser Family Foundation, January Effects of Electronic Media on Children Ages Zero to Six: History of Research

23 So What Can We Do?

24 Early Childhood Professionals Can: Limit television viewing and media exposure Limit television viewing and media exposure Use effective physical activity policies Use effective physical activity policies

25 Early Childhood Program Policies Matter

26 Why Develop Policies? For the health and safety of children and staff For the health and safety of children and staff A selling point for parents searching for a quality program A selling point for parents searching for a quality program To encourage open communication To encourage open communication To make sure everybody at child care follows the same rules To make sure everybody at child care follows the same rules

27 Regulations vs Policies Regulations: Regulations: Laws required by the state for licensure Laws required by the state for licensure Policies: Policies: The outline or rules a center uses to guide the way it runs its programs The outline or rules a center uses to guide the way it runs its programs General General Center wide policies Center wide policies Specific Specific Classroom policies Classroom policies

28 Making the Healthy Choice the Easy Choice ASSESS: ASSESS: How well your surroundings promote physical activity and limit screen time. How well your surroundings promote physical activity and limit screen time. Put into ACTION: Put into ACTION: A physical activity and screen time policy for your program A physical activity and screen time policy for your program Get SUPPORT: Get SUPPORT: From staff and parents From staff and parents FIND: FIND: Physical activity resources for yourself and your program. Physical activity resources for yourself and your program.

29 Sample Policy: TV Watching Because we care about the health and well being of the children in our care, we follow the American Academy of Pediatrics’ Recommendations on Television viewing: Children under 2 should watch NO TV Children under 2 should watch NO TV Children under 5 should watch no more than 2 hours of high quality programming a day (includes all screen time) Children under 5 should watch no more than 2 hours of high quality programming a day (includes all screen time)

30 Sample Policy: Physical Activity Because we care about the health and well being of the children in our care we have policies and practices that support PHYSICAL ACTIVITY. We include at least 3 teacher led physical activities per week involving large muscles for our toddlers and preschoolers. We include at least 3 teacher led physical activities per week involving large muscles for our toddlers and preschoolers. We strive to follow the NASPE GUIDELINES for young children. We strive to follow the NASPE GUIDELINES for young children.

31 NASPE Physical Activity Guidelines for Infants Infants should interact with caregivers in daily physical activities that encourage exploration of their environment. Infants should interact with caregivers in daily physical activities that encourage exploration of their environment. Infants should be placed in safe settings that facilitate physical activity and do not restrict movement for prolonged periods of time. Infants should be placed in safe settings that facilitate physical activity and do not restrict movement for prolonged periods of time. Infants' physical activity should promote the development of movement skills. Infants' physical activity should promote the development of movement skills.

32 Physical Activity Guidelines for Infants (continued) The environment should meet or exceed recommended safety standards. The environment should meet or exceed recommended safety standards. Care providers should be aware of the importance of physical activity and encourage physical activity in child care and early childhood facilities. Care providers should be aware of the importance of physical activity and encourage physical activity in child care and early childhood facilities.

33 Physical Activity Guidelines for Toddlers and Preschoolers Toddlers develop movement skills Toddlers develop movement skills Preschoolers develop competence in movement skills Preschoolers develop competence in movement skills Children need indoor and outdoor areas that meet or exceed recommended safety standards for physical activity Children need indoor and outdoor areas that meet or exceed recommended safety standards for physical activity Care providers should be aware of the importance of physical activity and should promote the child's movement skills Care providers should be aware of the importance of physical activity and should promote the child's movement skills

34 Other Resources for Supporting Healthy Policies in Your Child Care Setting: Healthy Habits Download Healthy Habits Materials at and click on Resources for families

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36 Policies Make a Difference at Home too! Youth in homes where rules for screen time use are in place watch 1 hour less TV per day Youth in homes where rules for screen time use are in place watch 1 hour less TV per day Youth in homes with video game rules spend 1/3 less time using video games Youth in homes with video game rules spend 1/3 less time using video games Policy are the same as rules Policy are the same as rules Kaiser Family Foundation, Kids & the New Millennium, March 2005

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39 For More Ways to Make Policies Work in Your Child Care Setting: See your provider packet: See your provider packet: Activities for young children Activities for young children Sample policies Sample policies NASPE guidelines NASPE guidelines Other resources for Providers and Parents Other resources for Providers and Parents Visit the Active Bodies, Active Minds website: Visit the Active Bodies, Active Minds website: Download Healthy Habits materials Download Healthy Habits materials Learn about the Washington State Nutrition and Physical Activity Plan Learn about the Washington State Nutrition and Physical Activity Plan Many more resources for Making the Healthy Choice the Easy Choice Many more resources for Making the Healthy Choice the Easy Choice