Baby books are filled with pictures of adorable babies--and often those babies have the large cheeks of a budding football linebacker. Chubby babies are undeniably cute but as children age, baby fat can go from cute to worrisome. And when excessive fat moves from adolescence to adulthood, serious and often life-threatening problems can result.

As a whole, America is overweight. Given the abundance of food in our country, not to mention the super-sized options available at almost every restaurant, this news comes as no surprise.

What is alarming, however, is the fact that being overweight is no longer an adult-sized problem. Toddlers and preschoolers are increasingly susceptible to the health effects of being overweight. The prevalence of being overweight for height has more than doubled in the past 30 years for children ages 2-5.

Concerns about being overweight extend beyond just the immediate issues. Weight problems may inhibit both emotional and social well-being, as well as contribute to long-term health risks.

The terms overweight and obese are often interchanged. However, an individual who is overweight is simply above the recommended weight for his height, whereas someone who is obese generally is over this mark by 20 percent or more.

People who are overweight typically have a large amount of body fat, as determined by the body mass index, or BMI. This calculation uses weight and height to determine a BMI score.

According to the National Institutes of Health, a BMI of 18.5-24.9 for adults is considered healthy, 25-29.9 is considered overweight, and 30 or greater is labeled obese. In some instances, other tools, such as measuring an adult’s waist circumference, may be necessary to accurately determine BMI.

For children, growth charts are typically used to compare height and weight ratios with others in the same age group. Such measurements may be helpful in determining weight issues--or a propensity toward obesity--at an early age.

However, some doctors warn against relying on this chart alone, as growth spurts are common and some children are simply large for their age, not necessarily overweight. Rather, parents and caregivers should consider the child’s BMI as well as his or her activity level, eating habits, and position on the growth chart before assigning an overweight label.

Typically, children are overweight due to a lack of physical activity and to unhealthy eating habits. According to the American Academy of Pediatrics (AAP), weight issues are associated with significant health problems in children. Being overweight can affect infants, toddlers, and preschoolers in the following ways:

• Impaired immune system. According to studies at the National Cancer Institute, being overweight can affect a person’s immune system and subsequent ability to fight off infection and disease. In children, this may lead to more frequent colds or other illnesses.
• Impaired cognitive development. The University of Florida recently discovered a link between toddlers who weighed more than 50 percent above their ideal body weight and low IQ scores, suggesting that delays in cognitive development could be a problem for overweight children younger than four years of age.
• Sleep apnea. According to experts at the University of Toledo, overweight children may suffer from sleep apnea, a disorder in which they awaken many times during the night, reducing the amount of time they spend in deep, recuperative sleep. This can affect school performance and also may lead to children being misdiagnosed with attention deficit hyperactivity disorder (ADHD).
• Dental development. An increased risk of cavities and other tooth abnormalities has not yet been confirmed in overweight children. But some experts assert that decreasing common dietary risk factors for obesity, such as sugary foods and drinks, may lead to a decrease in both tooth decay and weight.
• Inadequate social/emotional development. Overweight children may be bullied or excluded from social activities. This can lead to emotional problems, such as depression, anxiety, or even rage, in which children are hostile or aggressive toward their peers. Such problems may significantly affect a child’s social skills and self-esteem.

Children who are overweight are more likely to suffer from long-term ailments, such as asthma or Type 2 diabetes, a disease in which an individual’s body loses its ability to maintain normal blood sugar levels. Traditionally diagnosed in adults, Type 2 diabetes is becoming more prevalent in children and teenagers, with children as young as four years of age now having the disease.

Studies now show that a child’s fat stores are determined at an early age. Children who are overweight as toddlers are more likely to be overweight as adolescents and adults. Overweight preschoolers have a five times higher risk of being fat at age 12 than do lean preschoolers.

Unfortunately, habits--particularly those instilled in early childhood--are hard to break, making problems with weight more likely in adulthood. According to the AAP policy statement Prevention of Pediatric Overweight and Obesity, the risk of adult obesity increases from 20 percent in an overweight 4-year-old to 80 percent in an overweight or obese adolescent.

Individuals who remain overweight or obese throughout their lives are at increased risk for heart disease, diabetes, cancer, and bone, joint, and muscle problems. Risk for overweight increases dramatically when one, or particularly both, parent(s) is overweight showing that the family lifestyle--nutrition and fitness--is a factor in the weight of children.

Being overweight is about more than self-image; it is about overall health and well-being. The tools for preventing lifetime weight issues start at an early age. Caregivers help children to develop healthy habits by modeling appropriate behaviors, such as eating a variety of fruits and vegetables, limiting portion sizes, and participating in physical activities.

Setting a good example cannot only impact both the present and future well-being of the children in your care, but also improve your own health.

Diona Reeves, Consultant, American Academy of Pediatrics, Early Child Care & Education Initiatives

American Academy of Pediatrics, www.aap.org

Body Mass Index Calculator, www.nhlbisupport.com/bmi

Centers for Disease Control and Prevention, www.cdc.gov/nccdphp/dnpa/b

National Cancer Institute, www.cancer.gov

National Institutes of Health, www.nih.gov

Surgeon General’s Call to Action to Prevent and Decrease Overweight and Obesity, www.surgeongeneral.gov

My Healthy Child Growth Calendar, Healthy Child Publications, PO Box 624, Harbor Springs, MI 49740; 877-258-6178; www.healthychild.net

Obesity Action Coalition, 4511 N. Himes Avenue, Ste. 250, Tampa, Florida 33614; 800-717-3117; www.obesityaction.org