Byington, T. A., Lindsay, A., Sigman-Grant, M. J. 2014, Healthy choices start early, Journal of the National Association for the Education of Young Children, 69(5), 14-21

In the United States today, young children live in an obesogenic environment where relatively low-cost food is readily available and daily lifestyles promote sedentary behaviors, resulting in the increasing incidence of overweight (see “What Is an Obesogenic Environment?”) (Birch & Anzman 2010; Harrison et al. 2011). Obesity is a complex issue resulting from many different factors, including genetics, cultural preferences, parental behaviors, food consumption, media exposure, and activity level (Harrison et al. 2011). Almost one-third of US children are overweight or at risk for being overweight, which increases their probability of developing chronic illnesses such as high blood pressure, high cholesterol, and type 2 diabetes (CDC 2012). Although a recent survey suggests a leveling of obesity incidence (Ogden et al. 2014), data from the National Health and Nutrition Examination Survey, 1976–1980 and 2009–2010 (www.cdc. gov/nchs/nhanes.htm), shows that in the past, the prevalence of obesity increased for children ages 2 to 5 years from 5 percent to 12.1 percent, as measured by heights and weights and converted to body mass index (BMI) (Ogden et al. 2012). Obese children are more likely to have health concerns and become obese adults (CDC 2012). The Institute of Medicine (IOM) and others recommend that overweight prevention educational eforts start as early in life as possible (Gooze et al. 2010; IOM 2012).

In the preschool years children lay the foundation for future eating and physical activity behaviors (Lanigan 2011). Although families are primarily responsible for preschoolers’ food choices and physical activity habits, almost three-fourths of preschool-age children spend a large part of their day in care outside the home (Children’s Defense Fund 2011). Early care and education programs are important settings for obesity prevention efforts (Larson et al. 2011; Sigman-Grant et al. 2014). Thus, teachers and families often share the responsibility for teaching children about healthy eating and fitness practices during these important developmental years (Kaphingst & Story 2009).

The All 4 Kids program

To address childhood obesity, a team of faculty in early childhood education, exercise physiology/physical activity, and nutrition at the University of Nevada, Reno (Cooperative Extension), developed All 4 Kids, a program focusing on healthy lifestyle choices.

All 4 Kids was developed in 2008. The eight-week program (meets three times a week) targets preschoolers, their families, and preschool teachers in early childhood education centers. The program is based on the assumption that many children live in an obesogenic environment, and that direct teaching for preschool-age children and engagement of families and teachers can provide information about healthy eating and active living.

All 4 Kids consist of 21 preschool lessons and three family events. The program is designed to promote healthy habits while offering learning experiences that address Nevada State prekindergarten standards in early language and literacy, math, science, social studies/social-emotional development, creative arts, and physical development/ health (Nevada Department of Education 2010).

Rather than simply increasing active time, the program uses dance as the primary way to engage children in physical activity. Original songs from three popular genres— country rock, hip-hop, and Latin music—feature lyrics about healthy snack choices, physical activity, and acceptance of self and others at any size or shape. Preschoolers learn dance patterns with specific skills, such as crossing the midline, hopping on one foot, and balancing, to promote preschoolers’ fitness and physical skills development.

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