Changes to nutrition programs may be helping reverse the rising rate of childhood obesity, but the most effective changes are the ones parents make at home.

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How parents enforce rules they create to manage their kid’s diet can have a big impact on their child’s relationship with food in the future. Getty Images

Obesity among children is a fairly new problem in the United States. Rates of childhood obesity in the 1960s and 1970s were relatively low, with only 5 to 7 percent of kids qualifying as having obesity.

Today, the Centers for Disease Control and Prevention puts the rate of childhood obesity at 18.5 percent, with roughly 13.7 million children and adolescents being affected. That’s a huge leap over the course of just a few decades.

But recent research points to a potential decline in those numbers.

There are a lot of theories about the contributing factors to increasing childhood obesity rates.

The American Psychological Association points to an “obesogenic environment that promotes inactivity and overeating.”

But what does that mean, exactly?

Among the factors they consider contributing to this obesogenic environment are an increase in:

  • women working outside the home, accounting for less time spent on food preparation
  • fast-food and full-service restaurants
  • families dining out
  • the consumption of high-fructose corn syrup, especially in soft drinks and juices

Another factor is a decrease in physical activity. There's more driving, less walking and biking, and more time spent in front of screens as opposed to playing outdoors.

The conclusion is that society has seen a lot of changes over a short period of time that all contribute to less healthy lifestyles overall.

But there’s reason to believe that might be changing, with a June 2019 study finding a decline in childhood obesity rates.

There’s just one catch: The study examined a relatively small group of kids, only those between the ages of 2 and 4 enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) between 2010 and 2016.

“In 2014, the WIC package was changed for the first time since 1980,” American Academy of Pediatrics spokesperson Dr. Natalie Muth, also co-author of “The Picky Eater Project: 6 Weeks to Happier, Healthier Family Mealtimes,” told Healthline.

“The changes provided more fruits and vegetables and half the amount of juice. These changes are likely to be a lot of the reason for the decrease,” she said.

She points out that other studies haven't found a similar decrease in childhood obesity outside this very specific demographic. “In fact, the rates of severe childhood obesity have gone up,” she said.

Still, that doesn’t mean the study’s findings are without value. If nothing else, it shows that increasing awareness and encouraging different choices can make a difference on the childhood obesity epidemic.

“It’s good, because they made some changes to their program, and they were able to show a difference because of that,” childhood nutrition expert and registered dietitian Jill Castle told Healthline.

But she says there’s more to the story than just food and exercise.

“If you pressure kids to take more bites of food, or you restrict sweets to the point of exclusion, you can trigger kids into eating more. There’s this element of feeding that is pretty important in my opinion, and there’s also this lack of education around nutrition and feeding for parents in general, regardless of socioeconomic status,” Castle said.

In other words, health goes beyond just the choices being offered.

Family and child nutrition expert Katharine Jeffcoat, RDN, who describes herself as a health at every size (HAES) dietitian, agrees.

“The worst thing a parent can do is try to micromanage their child’s weight and use it as the main factor to determine their health,” Jeffcoat said.

It’s something she herself refuses to do in her own practice.

“Many factors determine weight, ones we can’t control, such as genetics,” she said.

Jeffcoat adds that she won’t determine a child is unhealthy based solely on the fact that they weigh more than their peers. Instead, she examines their cholesterol, triglycerides (TG), and A1C.

Jeffcoat explains that elevations in any of these areas is what put children at risk for heart disease and diabetes.

“I have met average-weight children with elevated cholesterol and TG also, so weight doesn’t specifically cause these health markers to be elevated. Lifestyle does,” she said.

Jeffcoat advises some of the best things parents can do to keep their children healthy include the following:

  • Offer fruits, vegetables, and whole grains on a regular basis.
  • Eliminate trans fats.
  • Reduce saturated fats.
  • Include more monounsaturated and polyunsaturated fats with nuts, seeds, avocados, and olive oil.
  • Involve the family in sports and activities that keep them active.
  • Make sure everyone gets plenty of sleep.

Castle agrees, adding that establishing healthy habits means having a good handle on what those habits look like without micromanaging how your child eats.

“Really good feeding practices involve not pushing your kids to finish their food and not strictly enforcing restrictions, such as no candy or soda, because that can push a desire for those things, leading to behaviors such as sneaking and overeating when they are available,” Castle said.

She also encourages parents to avoid bribing their kids with food.

“We want to set up a structure. Have boundaries, like closing the kitchen in between meals and snacks, and make parents in charge of what is served at mealtimes. But then allow kids to choose what and how much they’ll eat,” she said.

If you’re curious what that might look like, Castle has discussed mealtime rules with Healthline in greater detail in the past.

For her part, Muth wants to see parents focus on five behaviors she says can have the greatest impact on health and weight:

  1. Nutrition. Consume more fruits and vegetables and less sugary drinks.
  2. Physical activity. Provide opportunities for kids to be active at least 60 minutes a day, and even more for kids under the age of 5.
  3. Sleep. Follow a good sleep routine, such as the four Bs (bath, brush, book, bed). She says she likes to add a fifth B: Breathe.
  4. Screen time. Create rules around screen time. Never allow it during mealtimes or within one hour of bedtime.
  5. Stress management. Help kids learn to cope with stressors in a positive way, such as through taking deep breaths, physical activity, journaling, or talking about their problems.

There’s definitely reason to be concerned about any child who may be gaining too much weight.

“We know that obesity increases risk for health problems, such as prediabetes and type 2 diabetes, abnormal cholesterol levels, fatty liver disease, and heart disease. We are also concerned about the increased rates of depression, stigma, and bullying in children who have obesity,” Muth said.

But she adds that the most recent study “helps to show that policy changes can make a big difference.”

And not just policy changes to government programs, but also changes parents can make within their own homes.

Health is a choice families can make every single day. If you’re concerned about your child's diet, there's no better day to start making healthier choices than today.