How prepared is the dietetic profession for today's wicked childhood nutrition problems?

Abstract

How prepared is the dietetic profession for today's wicked childhood nutrition problems?Early childhood, commonly referred to as the first 2000 days, is now acknowledged as a critical time for the development of health behaviours that influence early growth and development, and can tract to adulthood. 1,2 Globally, approximately 41 million infants and young children have overweight or obesity, impacting highincome countries more than low-or middle-income countries. 3 In Australia, one in four children aged 2-5 years have overweight or obesity, with those living in lower socioeconomic or regional areas more affected. [4][5][6] Children are exposed to a range of environments including their home, family, caregivers and childcare services, which all play a significant role in influencing the early establishment of food preferences and dietary patterns. 7,8 Poor diet is a key modifiable risk factor for overweight and obesity. 9 Although Australia has evidence-based infant feeding guidance, 10 national dietary guidelines 11 and interventions 12 to inform healthy eating habits in early life, poor diet quality is evident from early childhood. 13 When we consider the three paradigms associated with the development of a child's eating-familiarisation, association and observation 14 -and the current obesogenic environment within which this is occurring, it is unsurprising that infants and young children are being repeatedly exposed to and forming preferences for unhealthy, ultra-processed foods and beverages that are not essential for health. An ever-expanding obesogenic environment requires a systemic approach, with multiple strategies that complement and extend current dietetic practices of awareness creation and education. 15 Cultural, social, 16 environmental and commercial 17 determinants of health all need consideration for the development of effective strategies that acknowledge individual diversity, provide supportive environments, and most importantly, become embedded into local, state and national policy.This issue highlights the many challenges faced by dietitians and other public health professionals internationally to achieve healthy eating behaviours amidst a changing, unhealthy, food supply. Onifade et al, Leonard et al and Cheung et al remind us of the importance of optimising dietary intakes of infants. [18][19][20] Their findings illustrate the influence of parental role modelling and