Recent headlines trumpeted the good news: Obesity rates among 3- to 5-year-olds appear to be decreasing. Yet the U.S. Centers for Disease Control and Prevention still report that as of 2012, more than a third of American children were either overweight or obese, and parents need to guide their kids toward healthy choices.

“Most experts agree that most toddlers who are ‘chubby’ probably are already obese,” says Dr. Doug Barton, a pediatrician with SSM Medical Group. “In infants, it’s harder to tell just by appearance.”

Body mass index (BMI), a calculation based on height and weight, is the most common tool for diagnosing obesity. Physicians compare a child's BMI to population-based norms. Children and infants with a BMI greater than the 95th percentile for age and sex are formally considered obese.

“This is a medical concern for children primarily because studies show that infants in the top 25th percentile for body mass index are 40 percent more likely to be obese as 3-year-olds,” Barton adds. Obese children are more likely than others to become obese adults with all the attendant risks of diabetes, high blood pressure and heart disease.

“Usually chubby babies will thin out between 9 months and 2 years of age as they become more physically active,” says Dr. Stephen Thierauf, a Mercy Kids pediatrician. “We’re going to be following an infant’s weight and growth starting at birth with every visit to the pediatrician. There’s a wide range of acceptable weights, with some infants being more ‘chubby’ and others more thin. This is often dictated by genetics. The weight gain between visits is important to follow. If this becomes excessive, calorie consumption and hormone problems should be considered.”

Thierauf advises parents to make fresh fruits and vegetables a dietary staple, be aware of portion control, and avoid giving children sugary drinks and juices. Parents are a child’s primary example when it comes to lifestyle, so adhering to a healthy diet and regular exercise as a family is helpful in preventing obesity.

Barton agrees and notes that parents shouldn’t let children dictate menus. “The most important thing in my mind is to give up the food fights,” he says. “Offer children healthy choices. If they don't want the healthy choices being offered, they aren't hungry. It’s very important not to give in to the urge to feed children something else just because they don't like what is being offered.”

Similarly, Barton advises parents not to worry if a child refuses to eat a meal. “From years of talking to parents and grandparents, the worst thing we do to children is try to get them to eat when they're not hungry,” he says. “If they’re not eating for the day, we worry that we have to offer something just to get them to eat. This is a huge problem.”

Modeling good diet and exercise behavior, being aware of a child’s BMI, and avoiding the traps of giving in to requests for sweets and sugary drinks are keys to helping healthy children become healthy adults.

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