May 2025

New NCCOR Publication Highlights Gaps in Measuring Children’s Physical Activity

May 2025, NCCOR

NCCOR’s latest publication, “Reliability and Validity of Physical Activity Measures for Children and Adolescents: The NCCOR Measures Registry Review,” analyzes the quality of physical activity measures included in the individual physical activity domain of NCCOR’s Measures Registry. The study examines the extent to which measures report on reliability and validity—two important indicators of scientific rigor—and identifies trends and gaps across age groups, settings, and measurement types. Notably, few entries included individuals from low socioeconomic or rural backgrounds, with 72% of entries not reporting participants’ socioeconomic status—highlighting the need for research that better reflects a variety of populations.

This review provides a snapshot of the current measurement landscape and offers insights for strengthening future data collection and evaluation in childhood physical activity research. By taking stock of existing tools, this review helps advance the field by promoting greater consistency and rigor in how data is collected, evaluated, and used. Reliable and valid measurement tools are essential for understanding what works, for whom, and in what settings—especially when designing and scaling interventions to improve children’s health.

As author Dr. Kimberly Clevenger explained, the findings point to “the need for more robust and consistent approaches to method development, increased accessibility of measurement tools, and greater inclusion of participants from diverse backgrounds.” Looking ahead, the authors encourage researchers to refine and validate existing tools—rather than create new ones—to build a stronger foundation of recommended, accessible measures. The publication also reinforces the value of NCCOR’s Measures Registry as a centralized resource for identifying high-quality tools to support research and practice.

Access the manuscript and other recent publications in NCCOR’s resource library.

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NCCOR Toolbox: Get Kids Moving with the Youth Compendium of Physical Activities

May 2025, NCCOR

May is National Physical Fitness and Sports Month—a great time to explore the Youth Compendium of Physical Activities, developed by NCCOR to support youth fitness and health. This innovative resource provides standardized estimates of the energy cost of a wide range of activities commonly performed by youth ages 6 to 18. From organized sports to everyday play, the compendium helps researchers, educators, and health professionals more accurately assess and promote physical activity in youth-focused settings. Whether you’re planning a school-based fitness initiative or evaluating a community sports program, the Youth Compendium offers a solid foundation for tracking and encouraging movement among children and teens. Learn more at www.nccor.org/tools-youthcompendium.

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The Weight of Our Children: New Mexico Childhood Obesity 2024 Update Report

March 2025, New Mexico Department of Health

Obesity is a serious health issue in New Mexico, particularly in children. Childhood obesity is a complex issue that is influenced by weight bias, socioeconomic status, food insecurity, and community infrastructure. Nearly one-in-four (24.7%) school-aged children in New Mexico live in poverty, compared to nearly one-in-six (15.7%) nationally in 2023, making New Mexican children more at risk for obesity than children in other states. Children who have obesity have a higher likelihood of developing high cholesterol, type 2 diabetes, hypertension, heart disease, stroke, fatty liver disease, sleep apnea, and depression. Childhood obesity and overweight are a primary public health concern. While weight and body size alone should not be considered causes of health or measures of health outcomes, the stigma associated with them should be. Rates of obesity and overweight can be used to assess exposure to stigma and unequal access to healthy eating and physical activity opportunities.

Inequities have a substantial health impact on the wellbeing of our communities. It is important to be able to identify where health inequities exist. Labeling people based on their bodies can be problematic; it can be used to assess exposure to stigma. The terms “obese” and “overweight” are used in this report, but these terms can also be stigmatizing and have a complex history.

This report provides the frequency of childhood obesity and overweight in New Mexico in fall 2024. Reduced involvement in the metro area is a limitation of this data. This report includes data from 2,946 students measured at 40 schools across 21 counties in fall 2024.

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Managing Obesity in Children: A Clinical Practice Guideline

April 14, 2025, Canadian Medical Association Journal

Background: Obesity is a complex, chronic, stigmatized disease whereby abnormal or excess body fat may impair health or increase the risk of medical complications and can reduce quality of life and shorten lifespan in children and families. We developed this guideline to provide evidence-based recommendations on options for managing pediatric obesity that support shared decision-making among children living with obesity, their families, and their health care providers.

Methods: We followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. We used the Guidelines International Network principles to manage competing interests. Caregivers, health care providers, and people living with obesity participated throughout the guideline development process, which optimized relevance. We surveyed end users (caregivers, health care providers) to prioritize health outcomes, completed 3 scoping reviews (2 on minimal important difference estimates; 1 on clinical assessment), performed 1 systematic review to characterize families’ values and preferences, and conducted 3 systematic reviews and meta-analyses to examine the benefits and harms of behavioural and psychological, pharmacologic, and surgical interventions for managing obesity in children. Guideline panelists developed recommendations focused on an individualized approach to care by using the GRADE evidence-to-decision framework, incorporating values and preferences of children living with obesity and their caregivers.

Recommendations: Our guideline includes 10 recommendations and 9 good practice statements for managing obesity in children. Managing pediatric obesity should be guided by a comprehensive child and family assessment based on our good practice statements. Behavioural and psychological interventions, particularly multicomponent interventions (strong recommendation, very low to moderate certainty), should form the foundation of care, with tailored therapy and support using shared decision-making based on the potential benefits, harms, certainty of evidence, and values and preferences of children and families. Pharmacologic and surgical interventions should be considered (conditional recommendation, low to moderate certainty) as therapeutic options based on availability, feasibility, and acceptability, and guided by shared decision-making between health care providers and families.

Interpretation: This guideline will support children, families, and health care providers to have informed discussions about the balance of benefits and harms for available obesity management interventions to support value- and preference-sensitive decision-making.

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Honoring Dr. Dianne Stanton Ward: A Legacy of Transformative Leadership in Childhood Obesity Prevention and Health Promotion

April 14, 2025, Childhood Obesity

It is with deep respect and admiration that we present this special issue of Childhood Obesity, celebrating the life and continuing contributions of Dr. Dianne Stanton Ward. Dr. Ward’s untimely passing in August 2023 has left an immeasurable void in the fields of public health and early childhood health and well-being, but her pioneering work continues to resonate through the efforts of countless individuals and organizations. Her groundbreaking research in early childhood nutrition, physical activity, and obesity prevention established her as a visionary leader in the public health community. Dr. Ward’s legacy is defined not only by her exceptional scholarly achievements in leadership, collaboration, and mentoring but also by her unwavering dedication to creating healthier environments for children and families. Her influence extends far beyond the university setting, impacting families and communities across the nation and the world.

Dr. Ward’s career, spanning several decades, was marked by transformative contributions to childhood obesity prevention and health promotion. After earning degrees in Physical Education from Coker College and the University of North Carolina at Greensboro, she began her academic career at Coker College and later joined the University of South Carolina (USC) in 1975, where she served for over 23 years. During her tenure at USC, Dr. Ward completed training in pediatric exercise physiology, and she was a founding faculty member of the Department of Exercise Science, the first unit of its type to be incorporated into an accredited school of public health. She rose through the academic ranks to the position of Professor of Exercise Science, and she served as Associate Dean and Interim Dean of the School of Public Health. Further, she established research collaborations with colleagues at USC, and she actively maintained those relationships through the remainder of her career.

In 1998, Dr. Ward took a new position as a professor in the Department of Nutrition and Associate Dean for Administration at the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill (UNC). While at UNC, Dr. Ward founded the Children’s Healthy Weight Research Group (now named the Community Health and Wellness Resource Team) within the Center for Health Promotion and Disease Prevention (HPDP), uniting students, staff, and faculty to develop, test, evaluate, and disseminate evidence-based programs and policies to improve children’s health through better nutrition and physical activity. Dr. Ward’s visionary and strategic leadership shaped many national initiatives on early care and education. For example, she was cochair of the Early Care and Education Innovation Collaborative of the Round Table on Obesity Solutions of the National Academies of Science, Engineering, and Medicine. She was research cochair of the Healthy Kids, Healthy Future Steering Committee and served in leadership positions on many other initiatives where she not only shared her expertise but was a generous and engaging collaborator.

In addition to her academic and research achievements, Dr. Ward was a dedicated mentor who nurtured the growth of countless students and trainees, providing rigorous guidance, personal support, and unwavering encouragement. Many of her mentees have gone on to become leaders in their fields, continuing her legacy of excellence in public health. As a researcher of international renown, Dr. Ward was not only a driving force behind groundbreaking public health initiatives but also a cherished mentor and colleague, inspiring others with her humility, dedication, and collaborative spirit.

One of Dr. Ward’s most significant and impactful contributions was the development and implementation of the Nutrition and Physical Activity Self-Assessment for Child Care (NAPSACC) initiative. Created in collaboration with the North Carolina Division of Public Health and Prevention Partners, with funding from the Centers for Disease Control and Prevention to HPDP, NAPSACC provides early childhood education settings with tools to guide improvements in nutrition and physical activity. The program’s success widely surpassed initial expectations, expanding beyond North Carolina to become a national and international model for health promotion in early care and education settings. The evolution of NAPSACC into Go NAPSACC, a suite of online tools, has further amplified its impact, benefiting over 500,000 children across 29 states and international programs. Dr. Ward’s vision for Go NAPSACC continues to shape the global landscape of childhood obesity prevention, with the program being adapted in countries, such as Australia and the United Kingdom.

While Dr. Ward’s contributions have transformed early childhood health promotion, her work also highlighted broader public health challenges that must be addressed to support children’s health and well-being. Early childhood (ages 0–5 years) is a critical period for promoting lifelong health, as behaviors related to physical activity, nutrition, and overall well-being established during this time profoundly impact long-term health outcomes. Research has demonstrated that early investments in health-promoting practices can yield significant benefits, such as improved physical and cognitive development, reduced risk of chronic conditions, and better overall quality of life. Settings such as early care and education play a powerful role in health promotion, given their reach and influence on children’s daily routines. Evidence-based interventions, such as Go NAPSACC, enhance nutrition and physical activity environments in these settings, contributing to healthier outcomes for children. However, sustained impact requires ongoing support, training, and resources. Dr. Ward’s work laid the foundation for these efforts by demonstrating how collaborative partnerships, capacity-building strategies, and continuous quality improvement can drive lasting change in early childhood, but more work and resources are needed.

This special issue of Childhood Obesity brings together a collection of manuscripts that reflect the scale and lasting impact of Dr. Ward’s work. These articles highlight innovative research and policy initiatives aimed at promoting healthy nutrition, physical activity, and overall health and well-being in early childhood. Topics include the dissemination and implementation of evidence-based interventions, longitudinal studies on healthy eating and physical activity practices, and the role of family and home environments in shaping children’s health behaviors. Additional contributions explore barriers and facilitators to healthy practices in child care settings, the impact of policy changes on early childhood education, and the development of tools to assess physical activity and nutrition in young children. In alignment with Dr. Ward’s commitment to mentorship, special consideration was given to submissions featuring student authors, ensuring her legacy of nurturing future public health leaders continues to inspire progress in the field.

As we celebrate Dr. Ward’s profound and continuing impact on the field of childhood health, this special issue serves as both a tribute to her life’s work and a call to action for continued progress in obesity prevention and health promotion during early childhood. Dr. Ward’s vision continues to shape the lives of children, families, and communities worldwide, even in her absence. The Go NAPSACC team, along with researchers and practitioners around the world, remains committed to advancing her legacy through evidence-based interventions and policy efforts aimed at improving the health of young children. We extend our gratitude to all contributors who have honored Dr. Ward’s memory through their scholarship and dedication. Her foundational work has paved the way for a healthier future, benefiting countless children who will experience the lasting impact of her contributions.

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It’s Time to Put the Nap in Nutrition and Physical Activity Self-Assessment for Child Care (NAPSACC): A Systematic Review Demonstrating the Impact of Child Care on Sleep Outcomes in Early Childhood

April 14, 2025, Childhood Obesity

Background: Child care-based interventions have largely neglected sleep as an important health behavior for obesity prevention. Child care sleep environments and caregiver practices likely differ from home sleep environments and parent practices.

Methods: We summarize findings of past research examining how child care arrangement, dose, and attendance impact young children’s sleep using steps outlined by the Preferred Reporting Items for Systematic Reviews and Meta-analyses methodology. Keywords related to sleep and child care were entered into PubMed, PsycINFO, and CINAHL, yielding a total of 3535 articles.

Results: Twenty-three studies were included in the data extraction process. There was evidence indicating that child care arrangement type, dose, and attendance impact various sleep outcomes among children 0–5 years old. Considerable variation across studies with regard to child care comparison groups and sleep outcomes assessed made making comparisons across studies difficult. However, child care outside the home and increased time spent in child care were commonly positively associated with daytime sleep and negatively associated with nighttime sleep. Child care outside the home was also associated with 24-hour sleep, with decreased sleep observed among infants and toddlers but increased sleep observed among preschool-age children receiving outside care, especially in settings with mandatory naptime.

Conclusion: The findings of this review demonstrate that child care impacts children’s sleep. More research is needed to understand best practices for promoting sleep across child care settings and inform intervention efforts. Integrating sleep into evidence-based child care obesity prevention interventions, such as Nutrition and Physical Activity Self-Assessment for Child Care, would assist in efforts to reduce obesity risk among young children.

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