Childhood obesity is a public health crisis both in the United States and, increasingly, worldwide. There are many causes of childhood obesity. They include the prevalence of food deserts — neighborhoods offering few healthy food options — targeted marketing of fast foods to children and, perhaps most importantly, parents’ poor choices and decision-making when it comes to the foods they feed their children.

Children from low-income families face more barriers to healthy eating than children of higher socioeconomic status. For example, they are more likely to live in neighborhoods with little easy access to fresh fruits and vegetables.

To avoid obesity in later life, it’s important to start educating mothers about how to feed their children early.

A new program launched and studied in Brazil found that with parent education, low-income families’ food choices could be altered to become healthier over time, resulting in a measurable reduction in calorie intake and body fat composition for their children by the age of six years.

Thirty-one public health centers in Brazil participated in the study, led by a team of researchers from Columbia University's Mailman School of Public Health and Brazilian University Universidade Federal de Ciências da Saúde de Porto Alegre. The children in the study were born between May 2008 and February 2009. The children were randomly assigned to an intervention or control group.

Staff members, doctors in the intervention group, targeted mothers’ feeding behavior in two ways: through informational posters in the clinic waiting rooms that discouraged offering sugary and fatty snacks to children under two, and by training healthcare workers in the clinics in the Brazilian dietary guideline for infant health, which they were then able to pass on to parents coming in for pediatric visits.

Healthcare centers randomized to the non-intervention group continued their routine medical assistance without any involvement of the research team. No materials were provided to these clinics.

The researchers found that the first year of a child’s life, particularly the transition from breastfeeding to solid foods, was the critical window for establishing healthy eating habits in young children.

“The message worldwide is that to avoid obesity later in life you cannot start too early to help mothers feed their children well,” co-author, Caroline N. Sangalli, a graduate student at the University of Porto Alegre, said in a statement. “[This] study is proof of principle that it is possible to change a mother's behavior.”

The dietary habits and feeding behaviors of the families that attended the public health centers throughout Brazil were also analyzed. The research team was most surprised by the sheer amount of highly caloric, sugary and fatty snacks and other “complementary foods,” as the study called them, offered regularly to children as young as six months of age.

Educating parents helped. Children and families who received the study’s health information intervention had lower overall calorie intake over time compared with those in the control group who did not. During follow-up visits at three years of age, children in the intervention group were consuming fewer carbohydrates and fat than children in the control group. At six years of age children in the intervention program had less body fat than children in the control group.

Even so, the overall calorie intake in both the intervention and the control group was still higher than nutritional guidelines recommended, a clear indicator that more research is needed to understand the best ways to help parents meet their children’s nutritional needs.

A key takeaway for parents from the study is that it’s never too early to help your children start developing healthy eating habits. In order to help prevent childhood obesity, parents need to be encouraged to follow the recommendations of dietary guidelines and avoid offering sugary and fatty foods like cookies, chocolate, soft drinks and highly processed baby foods to their children before the age of two.

More information about this study is available in the Journal of Human Nutrition and Dietetics.