AURORA, Colo. (November 19, 2024) – The Centers for Disease Control and Prevention reports one in five children and adolescents are considered obese, with even higher rates among children from low-income families and children from Black, Native American, and Hispanic populations. This alarming trend highlights the importance of the early childhood period in shaping behaviors that promote healthy weight practices and establish a foundation for healthy living.
The University of Colorado College of Nursing at Anschutz Medical Campus, under the Office of Research and Scholarship, has released its highly anticipated annual report, Achieving a State of Healthy Weight (ASHW) 2023. This comprehensive assessment evaluates how child care rules and regulations across all 50 states and the District of Columbia support obesity prevention in licensed child care programs. This year’s report marks the 13th annual assessment since 2010, providing invaluable insights into the state of child care regulations and their alignment with High-Impact Obesity Prevention Standards (HIOPS).
The report also analyzes the level of support across the US for 47 high-impact obesity prevention standards (HIOPS). The HIOPS are supported by licensing regulations in 64% of child care centers, and more than half of large family child care homes (58%) and small family child care homes (55%).
Child care licensing plays a pivotal role in enhancing the early care and education (ECE) environment, providing states with the opportunity to positively influence the health of a large number of children.
Annual ASHW studies examine new and revised state licensing regulations, allowing child care providers to implement regulations into daily routines. The most supported HIOPS in 2023 was providing children with a space for physical activity, making water available inside and outside, and serving age-appropriate food portions. The 2023 assessment found states had the greatest revisions relating to the 47 HIOPS since 2012. Infant feeding practices were most positively impacted in licensing regulations in 2023.
“Research has shown that embedding these HIOPS into statewide systems can impact the health of more than 12 million children who are eating, playing, and learning in child care across the country,” CU Nursing’s ASHW Principal Investigator Alison Pilsner, MPH, BSN, RN, CPH, IBCLC, says.
Key findings in this year’s study include:
- Tennessee leads the nation in support of the HIOPS
- Five states (GA, LA, SD, IL, WV) revised rules to strengthen breastfeeding support
- Texas banned all sugar-sweetened drinks, joining five other states (CA, IL, RI, TN, WV)
- Louisiana, South Dakota, and Pennsylvania made revisions to encourage more outdoor playtime to increase physical activity
- North Carolina and West Virginia created stronger regulations to limit screentime and digital media usage to educational or physical activity purposes
“As the 2023 ASHW report shows, each state has the opportunity to make impactful changes, transforming child care into a powerful tool for obesity prevention,” Pilsner says.
The study found that while states are making progress on guidelines and revisions for child care programs, more work needs to be done. Researchers found disparities still exist among licensed child care types, specifically between child care centers and family child care homes. States should also consider improving child care regulations, including ensuring consistency in regulatory changes across all licensed child care types. Other suggestions include aligning infant feeding and nutrition requirements with the current USDA Child and Adult Family Food Program (CACFP) meal patterns, and sustaining HIOPS language in licensing standards to provide children with a strong foundation for lifelong healthy behaviors.
“To effectively tackle disparities in obesity prevention, we must prioritize alignment across various types of child care,” Pilsner says. “Consistently implementing evidence-based obesity prevention strategies is essential to building healthier communities and enhancing health outcomes for all children.”
This study is supported by the Centers for Disease Control and Prevention, Division of Nutrition, Physical Activity, and Obesity, in the National Center for Chronic Disease Prevention and Health Promotion (subcontract #UDCN-02-4574, awarded by prime contract McKing Consulting Corporation).
About the University of Colorado Anschutz Medical Campus
The University of Colorado Anschutz Medical Campus is a world-class medical destination at the forefront of transformative science, medicine, education and patient care. The campus encompasses the University of Colorado health professional schools, more than 60 centers and institutes and two nationally ranked independent hospitals – UCHealth University of Colorado Hospital and Children's Hospital Colorado – which see more than two million adult and pediatric patient visits yearly. Innovative, interconnected and highly collaborative, the CU Anschutz Medical Campus delivers life-changing treatments, patient care and professional training and conducts world-renowned research fueled by $910 million in annual research funding, including $757 million in sponsored awards and $153 million in philanthropic gifts.
