Healthy Living


Our mission at the Foundation is to improve the health and well-being of all North Carolinians. However, we know that the first 2,000 days of a child’s life are the most critical developmental period in his or her lifetime. We recognize the opportunity to affect change at the earliest moments in life in order to set the trajectory for a healthier future. As obesity has become a major public health crisis, we have seen the struggle to affect change once a person is already overweight or obese. With investments in early childhood, we can prevent the issue before it starts. The health status of our state’s youngest children emphasizes the need to start early, as North Carolina’s rates of overweight and obesity in very young children are not trending down. Currently, almost three out of every 10 (28.5 percent) low-income young children ages 2-4 years are either overweight or obese. Over the past 30 years, the obesity rate has more than doubled among young children ages 2-4 years in North Carolina, increasing from 6.9 percent in 1981 to 15.4 percent in 2011.

Strategy: Early Childhood

Our children deserve more than just a healthy choice – they deserve a healthy start to life. By establishing an environment of health in the critical early years, we have the opportunity to focus on prevention. To do so, our investments in early childhood focus on policy, practice and environmental change with a specific focus in the child care and community settings. Early childhood has been a cornerstone of the Foundation’s strategy since its inception in November 2000. Be Active Kids® was the Foundation’s first Signature Program, developed in response to the lack of programming focused on physical activity and healthy eating for North Carolina children ages four and five. Over time, our strategy evolved from a focus on programs to a focus on the environments, policies and practices that shape the experiences for young children. As a result, we have made substantial investments in outdoor learning environments, assessments and technical assistance to promote best practices in nutrition and physical activity in child care, and a statewide strategy to impact health in early childhood. Additionally, we have expanded Be Active Kids® to focus specifically on developmentally appropriate movement and play from birth through age 5.

Grantee Spotlights

Shape NC

In 2011, the Foundation joined North Carolina Partnership for Children to create Shape NC. Shape NC is a six-year investment that layers best practices in early childhood with strong network building, technical assistance and community change strategies in order to increase the number of young children in North Carolina starting kindergarten at a healthy weight. Through the established statewide Smart Start network, Shape NC brings together the policy and practice strength of the Nutrition and Physical Activity Self-Assessment for Child Care (NAP-SACC), combines it with the built environment changes from Preventing Obesity by Design (POD), and the programming and training skills of Be Active Kids®. This creates a new network of trained local experts to provide ongoing technical assistance for child care centers. Shape NC is the first statewide initiative to combine multiple successful strategies and to implement both a top-down and bottom-up approach to improve the health of children in child care, their families and their communities. 

Be Active Kids

Be Active Kids® is our Signature Program focused on providing developmentally appropriate physical activity and play-related support and resources to individuals caring for young children in North Carolina. Be Active Kids® utilizes an evidence-based curricula developed by the Frank Porter Graham School for Child Development and various training modules to increase physical activity of both children and adults in early childhood settings. Be Active Kids® works with child care center, child care homes, and schools across North Carolina.

NCIOM Early Childhood Obesity Prevention Taskforce

Shape NC and our other early childhood investments are elements of a larger strategy to improve the health of North Carolina’s children. Shape NC convened a leadership task force to address the broad health issues facing young children and to produce a plan of recommended strategies and policy priorities for the state. The North Carolina Institute of Medicine’s (NCIOM) task force and resulting report are part of this larger effort to provide peer-reviewed and science-based cross-sectional opportunities to improve the health of our state’s youngest children.

Preventing Obesity by Design

Preventing Obesity by Design (POD) is aimed at reversing the trend toward childhood obesity by improving the outdoor environmental diversity of child care centers. Research suggests that this program can increase children’s levels of physical activity, increase time spent outdoors by children and teachers, and increase children’s awareness of vegetables, fruit, and nuts as healthy foods. POD considers design of outdoor environments in early childhood as a preventive health intervention.


Go NAP SACC is an online assessment program that uses stakeholder input and research to make informed and healthy improvements to childcare settings. The program provides resources for care providers of children from birth through 5 years, including a focus on breastfeeding and infant feeding, screen time, and outdoor play. Go NAP SACC also tailors tools and recommendations for different child care settings, including family child care homes.