Peer-reviewed article
Reframing the early childhood obesity prevention narrative through an equitable nurturing approach
Helen Skouteris, Heidi J. Bergmeier, Scott D. Berns, Jeanette Betancourt, Renée Boynton‐Jarrett et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This paper proposes a new framework for understanding and preventing childhood obesity in early life by focusing on nurturing care and equity rather than individual behavior change. It argues that obesity prevention should consider the broader social and economic contexts that affect child development from conception through age 5, including poverty and food insecurity. The authors recommend extending obesity prevention efforts across the first 2,000 days and involving marginalized families as partners in designing solutions. They emphasize that addressing racism and social determinants, not just race or ethnicity, is essential to equitable obesity prevention.
Key points
- High-quality mother-child interactions during the first 2,000 days are crucial for preventing obesity development
- Both undernutrition and obesity coexist in inequitable social conditions, sharing common drivers like poverty and food insecurity
- Current obesity prevention narratives lack a holistic life-course approach integrated with equitable developmental perspective
- Four key elements for reframing include: extending focus to 2,000 days, emphasizing nurturing relationships, recognizing racism as a social determinant, and codesigning interventions with marginalized communities
- Asset-based engagement of families and communities could drive transformation of policies and systems to prevent childhood obesity
Limitations
This is a conceptual paper presenting a framework rather than empirical evidence of intervention effectiveness. It does not evaluate specific obesity prevention programs or provide data on outcomes from implementing this equitable nurturing care approach.
Abstract
High-quality mother-child interactions during the first 2,000 days, from conception to age 5 years, are considered crucial for preventing obesity development during early life stages. However, mother-child dyads interact within and are influenced by broader socio-ecological contexts involved in shaping child development outcomes, including nutrition. Hence, the coexistence of both undernutrition and obesity has been noted in inequitable social conditions, with drivers of undernutrition and overnutrition in children sharing common elements, such as poverty and food insecurity. To date, a holistic life-course approach to childhood obesity prevention that includes an equitable developmental perspective has not emerged. The World Health Organization (WHO) Nurturing Care Framework provides the foundation for reframing the narrative to understand childhood obesity through the lens of an equitable nurturing care approach to child development from a life-course perspective. In this perspective, we outline our rationale for reframing the childhood narrative by integrating an equitable nurturing care approach to childhood obesity prevention. Four key elements of reframing the narrative include: (a) extending the focus from the current 1,000 to 2,000 days (conception to 5 years); (b) highlighting the importance of nurturing mutually responsive child-caregiver connections to age 5; (c) recognition of racism and related stressors, not solely race/ethnicity, as part of adverse child experiences and social determinants of obesity; and (d) addressing equity by codesigning interventions with socially marginalized families and communities. An equitable, asset-based engagement of families and communities could drive the transformation of policies, systems and social conditions to prevent childhood obesity.