The substance and sources of young children's healthy eating and physical activity knowledge: implications for obesity prevention efforts

Background The prevalence of overweight among young children is increasing at an alarming rate. Global efforts to address the issue can benefit from understanding how young children's experiences across multiple contexts shape their perspectives of healthy weight. Methods This qualitative study examines the substance and sources of young American children's knowledge related to healthy eating, physical activity and media practices. Role play and semi-structured interviews were conducted in child-care settings with 81 children aged 3-5 who represented diverse socio-economic statuses and ethnic backgrounds. Results Children demonstrated better understanding of the benefits of healthy eating compared with physical activity. Snacks and beverages consumed outside mealtime were less likely to be healthy even among the 40% of children who demonstrated an understanding of healthy nutrition. The majority of children's leisure activity selections involved media and minimally active pursuits. Three quarters of the children were unable to articulate reasons for healthy choices or identify the sources of their health understandings. The media was listed as source of health information more frequently than adults. Conclusion Obesity prevention efforts targeting young children need to use consistent messaging across all contexts in which children develop in order to increase their understanding that physical activity and eating choices support health. Efforts need to counter inaccurate information and address the rationale for health practices. Key gaps in young children's understanding include: the importance of drinking water, that snacks are part of nutritional intake and the benefits of engaging in physical activities.