Primary Prevention of Childhood Obesity

Recommendation 1.1: Routinely assess children’s nutrition, physical activity, sedentary behaviour, and growth according to established guidelines, beginning as early as possible in a child’s lifespan.

Recommendation 1.2: Assess the family environment for factors (e.g. parenting/primary caregiver influences and socio-cultural factors) that may increase children’s risk of obesity.

Recommendation 1.3: Collaborate with school leaders to assess elementary-school environments for risk and protective conditions that influence childhood obesity, including: 

• student demographics, 
• school policies, and 
• food and physical activity environments.

Recommendation 1.4: Assess neighbourhoods for community-level risk and protective conditions that influence childhood obesity

Recommendation 2.1: Engage community stakeholders when planning primary-prevention interventions for childhood obesity. 

Recommendation 2.2: Develop interventions that are: 

• universally applied, as early as possible, 
• targeted toward multiple behaviours, 
• implemented using multiple approaches, 
• inclusive of parents/primary caregivers and the family, and 
• implemented simultaneously in multiple settings.

Recommendation 3.1: Support exclusive breastfeeding for the first six months of life followed by breastfeeding and complementary feeding up to two years of age or beyond.

Recommendation 3.2: Provide education and social support to help parents/primary caregivers to promote healthy eating and physical activity in infants and toddlers.

Recommendation 3.3: Collaborate with parents/primary caregivers, educators and support staff (e.g. teachers, child care providers, school leaders) to promote healthy eating and physical activity in all settings where preschool children gather.

Recommendation 3.4: Collaborate with school communities to promote regular physical activity among elementary-school children.

Recommendation 3.5: Facilitate and support the integration of health and nutrition education into elementary-school programs and support the improvement of the school food environment.

Recommendation 4.1: Monitor and evaluate the effectiveness of the family’s approach to healthy eating and physical activity.

Recommendation 4.2: Evaluate the effectiveness and sustainability of school- and community-based primary-prevention initiatives.

Recommendation 4.3: Advocate and support the evaluation of an organization’s compliance with healthy public policies, and the impact of such policies on childhood eating behaviours and physical activity.

Recommendation 5.1: Incorporate foundational primary-prevention curricula based on this Guideline into the undergraduate education of nurses and other health-care providers.

Recommendation 5.2: Health-care professionals should participate in continuing education to enhance their ability to support the positive behavioural and environmental changes for children, families, and communities recommended in this Guideline.

Recommendation 6.1: Collaborate with organizations to develop, promote, and implement comprehensive and enforceable healthy public policies that impact healthy eating and physical activity in all childhood settings.

Recommendation 6.2: Collaborate with organizations to establish, or critically examine and work to improve, healthy public policies that address children’s physical activity and built environments.

Recommendation 6.3: Collaborate with organizations to establish, or critically examine and work to improve, healthy public policies that address the school food environment and the marketing of unhealthy food and beverages to children.

Recommendation 6.4: Collaborate with organizations and the broader community to establish, or work to improve, healthy public policies that address the barriers to health equity.

Recommendation 6.5: Advocate for the establishment of a comprehensive population-level surveillance system to monitor risk and protective conditions for childhood obesity, including: 

• prevalence of healthy weights,
• physical activity and healthy eating,
• socio-economic factors such as the prevalence of poverty, and 
• prevalence and duration of breastfeeding and exclusive breastfeeding.