As the number of obese childeren in the U.S. increases, a new study finds guidelines aimed to prevent childhood obesity are not being followed, according to researchers from the Cincinnati Children's Hospital Medical Center.

The 5-2-1-0 guidelines recommend that kids eat at least five servings of fruits and vegetables a day, spend less that two hours in front of a screen (including TV, computers, video games and mobile devices), fit one hour of physical participation into their day and that they consume zero sugar-sweetened drinks. The guidelines, which have been promoted nationally, suggest that children trade soda, fruit juice and sports drinks with water or low-fat milk.

For the study, researchers observed children’s diet and physical activity for 24 hours. Researchers looked into dietary intake, screen time, body mass index at child care and at home, and used accelerometers to measure physical activity.

Among 400 preschool children only one child followed the prevention guidelines over the the course of a single day at daycare and at home, researchers found. The study found one in four children had a body mass index that labeled them as overweight. Researchers found only 17 percent of children followed the five servings of fruit and vegetables rule.

“The recommendation that we believe is the hardest for families to attain, based on our study and other similar studies, is fruit and vegetable intake,” lead author of the study, Dr. Amrik Singh Khalsa, told International Business Times. “Several studies including evaluations of national datasets have showed that children and adults do not meet fruit and vegetable recommendations and it is due to diet quality.”

Meanwhile, half of the children failed to keep away from sugar-sweetened beverages. The study also found 81 percent of children had less than two hours of screen time, but less than one percent met the one-hour physical activity rule.

“While disregard of the guidelines does not necessarily equate to a child becoming obese, following the guidelines can lead to healthier lives,” Khalsa pointed out. “Because preschool-aged children who are obese have a four-fold odds of being overweight or obese as adults, it is important to establish healthy diet and lifestyle behaviors early in life."

Khalsa said there are various reasons why the guidelines are not being followed. One of them is the increase in tech usage at a younger age.

“The overall increased use of technology, i.e. screen time, which leads to sedentary behaviors, which has become increasingly more common even at a young age,” he said. “This is coupled with the lack of adequate physical activity which further increases the risk of obesity.”

The “higher availability for low-nutritious, processed foods, including junk food, fast food and sugary drinks is also to blame, and heavy marketing to promote them,” also play a part in the lack of the guidelines’ attainment, Khalsa said.  

“These foods tend to be cheaper than fruits and vegetables,” he added.

Childhood Obesity In The US

The number of U.S. children with obesity has more than tripled since the 1970s, the Centers for Disease Control and Prevention said this year. Approximately one in five minors ages 6-19 in the United States are currently obese.

Childhood obesity can lead to immediate and long-term impacts on physical, social, and emotional health, experts say. Kids with obesity are at higher risk for having diseases and chronic health issues, like asthma, sleep apnea, bone and joint problems, type 2 diabetes, and risk factors for heart disease. Children that are overweight can also lead to an adulthood with obesity, which is linked to serious conditions and diseases, like heart disease, type 2 diabetes, metabolic syndrome, and several types of cancer.

“ [...] Obesity in childhood significantly increases the risk of obesity as an adult and is harder and more expensive to treat obesity than prevent it,” said Khalsa.

Childhood obesity can also take an emotional toll on minors, as obese children tend to be bullied and teased more than those with normal weight. They are also more likely to suffer from social isolation, depression, and lower self-esteem, experts say.

The recent study, published online in the journal Preventive Medicine Reports, is believed to be the first to look into the attainment of the guidelines among preschool children who attend full-time child cares. The findings are part of the Preschool Eating and Activity Study (PEAS), the first study that analyzes preschool influences on kids’ physical activity over a single day and over multiple weather scenarios.