TMA Testimony by Kimberly Avila Edwards, MD, FAAP
Senate Health and Human Services Committee
Senate Bill 952
Updating Child Care Nutrition, Physical Activity, and Screen Time Standards
Testimony submitted on behalf of:
- Texas Pediatric Society
- Texas Medical Association
- American Heart Association Texas
- Public Health Coalition
- Partnership for a Healthy Texas
March 12, 2019
Good morning, Chair Kolkhorst and Committee Members,
My name is Dr. Kimberly Avila Edwards, and I am a pediatrician who has practiced in the Austin area for the past 17 years. I now serve the Level 1 trauma children’s hospital for the region. I am here today testifying on behalf of the Texas Pediatric Society, the Texas Medical Association, the American Heart Association, the Texas Public Health Coalition, and the Partnership for a Healthy Texas. Together these associations and coalitions represent more than 50 health care organizations dedicated to improving the health outcomes of our youngest Texans. As a medical professional and a mother of two, I appreciate the opportunity to testify in firm support of Senate Bill 952.
The Burden of Obesity on Our Children
My role as a pediatrician is extremely rewarding because preventive interventions in the early years have a lasting impact on a child’s life. This is no truer for me than when I counsel the children I work with, as young as 2, who already show signs of overweight and obesity and the complications that accompany these diseases. My clinical practice has centered around helping kids and their families learn healthy nutrition and activity habits, including putting down the iPad in favor of playing outdoor games. The consequences of children not learning these healthy habits can be disastrous:
- Children who are at an unhealthy weight as preschoolers are five times more likely to be overweight or have obesity as adults.
- Sixty percent of children who are overweight at age 5-10 already have one or more risk factors for heart disease and diabetes.
- Obesity is linked with many metabolic disorders that formerly were seen primarily in adulthood but now are manifesting in children. Examples include high blood pressure, high cholesterol, type 2 diabetes, nonalcoholic fatty liver disease, polycystic ovary syndrome, and disordered breathing during sleep.
- Even when these conditions do not appear in childhood, children with obesity are at increased risk for developing these medical complications during adulthood.
Unfortunately, our state already sees high rates of pediatric obesity. About one in four children aged 2-5 have overweight or obesity.4 While this health issue is present in all Texas communities – rural, suburban, and urban – some Texas children are at a higher risk. One in seven (14.9 percent) of 2-4-year-olds from low- income Texas families have obesity, a rate that exceeds the national average for this age group.
Decreasing the burden of early childhood overweight and obesity, which begins with creating environments where healthy habits are the norm, ultimately will reduce health care costs in our state and help kids succeed in school. Being physically active and having a healthy diet before age 5 is associated with improved child development and cognitive outcomes.6 For example, research shows that young kids who eat a healthy diet – high in lean protein and fresh fruits and vegetables – are more likely to have a higher IQ at age 8. In contrast, dietary patterns high in processed foods and added sugars are associated with lower school achievement and nonverbal reasoning.
Healthy Environments Foster Lifetime Healthy Habits
It is the role of primary care pediatricians such as I to counsel our patients’ families on the best ways to keep their children safe, happy, and healthy – whether that is via mental health screenings, injury prevention anticipatory guidance, or advice on the best foods to maintain a healthy weight. I discuss and encourage my parents to adopt healthy nutrition lifestyles for themselves and their children beginning at birth, and I encourage physical activity and limited screen time beginning at my first visits with families. I also encourage my families to seek and expect similar standards and practices when selecting child care facilities because children’s environments – where they spend most of their day – are critical to forming healthy habits.
This is why I believe SB 952 is so crucial to the health of the children for whom I care. All child care options available to a family throughout Texas should meet best practice standards endorsed by the American Academy of Pediatrics (AAP). I would expect nothing less for my own children, and I want to ensure my patients are guaranteed the same basic level of healthy habit-forming environments.
SB 952 updates current child care standards in three main areas:
- Nutrition – The bill adopts the standards of the U.S. Child and Adult Care Food Program, which is the premier standard for early childhood nutrition. The latest revision was informed by the AAP Committee on Nutrition specifically in the area of infant feeding before age 2.
- Physical activity – The bill adopts Caring for Our Children (CFOC) standards that include the most up-to-date research and best practices for promoting health and preventing childhood obesity in child care. CFOC is supported by the Centers for Disease Control and Prevention, AAP, and the American Public Health Association.
- Screen time – Screen time standards also are being brought in line with the AAP-endorsed Caring for Our Children best practice to ensure children maintain healthy brain development.
Thank you for the opportunity to provide testimony in support of SB 952 to help ensure our children are growing up in the healthiest environments possible.
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