Contrary to popular opinion, poor diet and lack of exercise aren’t risk factors for childhood obesity; they are the result of risk factors. A more compelling (and accurate) question, and one that researchers from the University of Illinois sought to answer in their recent study, is: What motivates that lifestyle?

Childhood obesity in the United States has expanded to an astonishing level. In the last 30 years, it’s more than doubled in children and tripled in adolescents, according to the Centers for Disease Control and Prevention. In 2010, the latest year the data is available, more than one third of all children and adolescents were overweight. The problem has many intertwined parts, such as the decline of physical education and recess in favor of child safety, but Illinois researchers claim to have found three risk factors that, even when controlling for the other 19 factors in their study, still significantly predicted childhood obesity.

"We looked at 22 variables that had previously been identified as predictors of child obesity, and the three that emerged as strong predictors did so even as we took into account the influence of the other 19,” Brent McBride, an Illinois professor of human development and director of the university's Child Development Laboratory, said in a statement. “Their strong showing gives us confidence that these are the most important risk factors to address."

Following In Healthy Footsteps

These factors were: 1) poor or inadequate sleep; 2) parents whose body mass index put them in an overweight or obese range; and 3) lack of parental restriction when it comes to the child’s diet. The team reached this conclusion after culling data on 329 parent-child pairs — through surveys, home visits, measures of height and weight — as part of the University’s STRONG (Synergistic Theory and Research on Obesity and Nutrition Group) Kids Program. First measures of the longitudinal study were taken when the children were 2 years old.

Since the American Medical Association’s recent classification of obesity as a disease, rather than simply a condition that predicts disease, much of the country has reconsidered its stance on overweight and obese people — showing mercy for genetic predispositions or hormonal imbalances where, previously, lack of will seemed the only cause. But one of the things McBride finds hopeful about his team’s study is that the three risk factors aren’t set in stone. People can change.

"What's exciting here is that these risk factors are malleable and provide a road map for developing interventions that can lead to a possible reduction in children's weight status,” he said. Parents should focus less on forcing broccoli and Brussels sprouts down a child’s throat and more on leading by example. Rather than make the difficult choice not to eat junk seven days a week, make the decision once, at the supermarket, and decide not to buy it.

These smaller choices are part of a larger holistic approach, McBride says. Remove sweets from the house, and kids won’t crave them. Be active more regularly with your kids, and they’ll appreciate the balance of energy and fatigue — hopefully preparing them for a restful night’s sleep. Co-researcher and graduate student, Dipti A. Dev, affirmed healthy children largely as products of healthy parents.

"If you, as an adult, live in a food environment that allows you to maintain an elevated weight, remember that your child lives in that environment too,” she said in the release. “Similarly, if you are a sedentary adult, you may be passing on a preference for television watching and computer games instead of playing chasing games with your preschooler or playing in the park.”

It can go too far, of course. Dev cautioned parents not to ban snacks entirely, as it can actually have the opposite effect (and can apply to a raft of behaviors, outside of personal diet). Basically, kids who grow up deprived of chips will, at the first chance they get, engorge themselves with chips — or whatever else it was their parents said was off-limits.

What’s most important is a balance. Parents should keep a range of fruits, vegetables, and healthy snacks around the house in order to groom kids into that mindset. Psychologically, kids gain or lose tastes for certain foods based on their exposure levels around pre-school age. “And remember that it takes a certain number of exposures to a food before a child will try it, let alone like it,” McBride said, “so you have to offer it to them over and over and over again. And they have to see you eat it over and over.”

Source: Dev DA, McBride BA, Fiese BH, Jones BL, Cho H. Risk factors for overweight/obesity in preschool children: an ecological approach. Childhood Obesity. 2013.