Preventing Obesity by Improving Children’s Environments

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As Dr. Pooja Tandon watched an increasing number of overweight children come through her office, she came to an uncomfortable realization: traditional weight-loss strategies frequently did not work.

“As a family’s general pediatrician, I could recommend that parents try to change their child’s diet or help them get more exercise,” she says, “but those behavior changes were not easy to make.

As such, Tandon shifted her focus to research, joining Seattle Children’s Research Institute in 2009 with the goal of finding better ways improve families’ health. Her work investigates how policy changes and other public health interventions might prevent obesity and other problems.

“If we can influence the environments that families operate in, maybe we can have a more powerful impact on their behavior,” she says.

One of Tandon’s first projects monitored whether menu-labeling requirements spurred families to eat healthier meals. King County was one of the first U.S. counties to require certain restaurants to display how many calories are in their food. Participants in Tandon’s study said this influenced them but, when Tandon looked at what the families actually bought, they didn’t choose lower-calorie meals.

“Maybe the best approach is for restaurants to change what they offer – maybe they just shouldn’t have 2,000-calorie burgers on the menu,” she says.

Because people’s eating habits result from complex influences, Tandon thinks it might be easier to increase children’s activity levels than to change what they eat. Much of her current work focuses on finding ways for children to spend more time outside, which could prevent obesity by increasing children’s physical activity levels and have many other health benefits.

She is currently preparing an innovative study that uses accelerometers – high-tech devices that measure how many steps a person takes – and GPS devices to pinpoint how active children are when they’re outside compared to inside. This will provide crucial data about whether outdoor play actually increases physical activity.

In a related study, Tandon found that nearly half of all preschoolers aren’t taken outside by their parents to play once a day. Since many of these children spend much of their time in child care facilities, Tandon is testing curriculum changes and other approaches that could spur child care providers to add more outdoor play to their daily routine. This could lead to new policies that require providers to have a minimum amount of outdoor play time.

It’s all part of Tandon’s larger attempt to make sure all children have the opportunity to lead healthy lives, regardless of their background.

“Children with lower socioeconomic status have less access to healthy food and have higher obesity rates,” she says. “My goal is to help create policies that level that playing field so that healthier choices are easier choices for everyone.”