October 31, 2007
This is the title of a popular show on TLC, where parents of overweight children are given the chance to see a computerized version of what their children may appear like in 30 years if they keep up their eating and lifestyle pattern of today.
THESE PICTURES ARE NOT PRETTY!!!
This generation of children is the first in history to potentially have a shorter life span than their parents. This three part series will examine the causes behind this epidemic, risk factors involved, and present some solutions to help turn this disturbing trend in the right direction.
The incidence of childhood obesity is rapidly rising throughout the world. The obesity epidemic is especially evident in industrialized nations where many people live sedentary lives and eat more convenience foods, which are typically high in calories and low in nutritional value. In just two decades, the prevalence of overweight doubled for U.S. children ages 6 to 11 — and tripled for American teenagers.
The annual National Health and Nutrition Examination Survey by the Centers for Disease Control and Prevention found that about one-third of U.S. children are overweight or at risk of becoming overweight. In total, about 25 million U.S. children and adolescents are overweight or nearly overweight.
Changes in the living environment (how we live, eat and act) is the major factor that has contributed to the current problem. There have been several dietary changes that have transpired over the last 20 to 30 years which have contributed to obesity.
One major factor is the frequency with which people eat out. It is now estimated that approximately 40 to 50 percent of every dollar that is spent on food is spent on food outside the home (i.e. restaurants, cafeterias, sporting events, etc.). When people eat out they tend to eat a larger quantity of food (calories) than when they eat at home.
Also, foods that are consumed in restaurants tend to have more fat (higher caloric density) which in turn contributes to excessive intake of calories. This also tends to be true for meals purchased in the school cafeteria. Providing children with money to buy their lunch at school also poses another potential problem.
Portion sizes have also increased. This is true for packaged foods and fast food restaurants. Take french fries for example. A portion size is actually 12 french fries. Most fast food restaurants have small or medium french fries, but sell more large or extra-large french fries. People do not think that a large order may actually be two or three portions.
Also, soda sizes have significantly increased. The average serving size of a soda was 6 and a half ounces in 1950, and increased to 12 ounces in the 1960’s and 20 ounces in the 1990’s.
Currently, 24 and 32 ounce sodas are marketed, with a 32 ounce soda containing approximately 400 calories. The consumption of soda by children has increased throughout the last 20 years by 300 percent. Fifty to more than 80 percent of children consume at least one soda per day and 20 percent of children consume more than four per day. Scientific studies have documented a 60 percent increase risk of obesity for every regular soda consumed per day.
Box drinks, juice, fruit drinks and sports drinks present another significant problem. These beverages contain a significant amount of calories and it is estimated that 20 percent of children who are currently overweight are overweight due to excessive caloric intake from beverages.
Another major factor in contributing to the pediatric obesity epidemic is the increased sedentary lifestyle of children. School-aged children spend most of their day in school where their only activity comes during recess or physical education classes. In the past, physical education was required on a daily basis. Currently, only eight percent of elementary schools and less than seven percent of middle schools and high schools have daily physical education requirements in the U.S.
Children are also more sedentary outside of school, which is due to increased time spent doing sedentary activities such as watching television, playing video games or using the computer. Only 50 percent of children, 12 to 21 years of age, regularly participate in rigorous physical activity, while 25 percent of children report no physical activity. The average child spends two hours a day watching television, but 26 percent of children watch at least four hours of television per day.
Studies indicate that when children watch more than two hours of television per day there is a significant increased risk of obesity as well as high blood pressure. Studies have also determined that children who eat in front of the television consume higher fat and salt containing foods and less fruits and vegetables than children who do not eat in front of the TV.
Staggering Statistics
- Only eight percent of elementary schools, and less than seven percent of middle schools and high schools, have daily physical education requirements in the U.S.
- Only 50 percent of children, 12 to 21 years of age, regularly participate in rigorous physical activity
- Twenty-five percent of children, 12 to 21 years of age, report no physical activity
- The average child spends two hours a day watching television
- Twenty-six percent of children watch at least four hours of television per day
How do you know if your child's weight gain is normal and when it's leading to childhood obesity? Children, unlike adults, need extra nutrients and calories to fuel their growth and development. So if they consume about the number of calories they need for daily activities, growth and metabolism, they add pounds in proportion to their added inches. But children who eat more calories than they need gain weight beyond what's needed to support their growing frames. In these cases, the added weight increases their risk of obesity and weight-related health problems. Childhood obesity is particularly troubling because the extra pounds often start kids on the path to health problems that were once confined to adults, such as diabetes, high blood pressure and high cholesterol. One of the best strategies to combat excess weight in your children is to improve the diet and exercise levels of your entire family. This helps protect the health of your children now and in the future.
Although there are some genetic and hormonal causes of childhood obesity, most excess weight is caused by kids eating too much and exercising too little. If children consume more calories than they expend through exercise and normal physical development, they gain weight. Far less common than lifestyle issues are genetic diseases that can predispose a child to obesity. These diseases, such as Prader-Willi syndrome and Bardet-Biedl syndrome, affect a very small proportion of children. In the general population, eating and exercise habits play a much larger role.
Many factors - usually working in combination - increase your child's risk of becoming overweight:
- Diet. Regular consumption of high-calorie foods, such as fast foods, baked goods and vending-machine snacks, contribute to weight gain. High-fat foods are dense in calories. Loading up on soft drinks, candy and desserts can also cause weight gain. Foods and beverages like these are high in sugar and calories.
- Inactivity. Sedentary kids are more likely to gain weight because they don't burn calories through physical activity. Inactive leisure activities, such as watching television or playing video games, contribute to the problem.
- Genetics. If your child comes from a family of overweight people, he or she may be genetically predisposed to put on excess weight, especially in an environment where high-calorie food is always available and physical activity isn't encouraged.
- Psychological Factors. Some children overeat to cope with problems or to deal with emotions, such as stress or boredom. Their parents may have similar tendencies.
- Family/Social Factors. Most children don't shop for the family's groceries. Indeed, parents are responsible for putting healthy foods in the kitchen at home and leaving unhealthy foods at the store. You can't blame your kids for being attracted to sweet, salty and fatty foods; after all they taste good. But you can control much of their access to these foods, especially at home.
Certain hard-to-control factors also can contribute to your child's risk of becoming obese. For example, children from minority or low-income backgrounds are at greater risk of becoming obese. Poverty and obesity often go hand in hand because low-income parents may lack the time and resources to make healthy eating and exercise a family priority.
As part of regular well-child care, the doctor calculates your child's body mass index (BMI) and determines where it falls on the national BMI-for-age growth chart. The BMI indicates if your child is overweight for his or her age and height.
Using the growth chart, your doctor determines your child's percentile, meaning how your child compares to other children of the same sex and age. So, for example, you might be told that your child is in the 80th percentile. This means that compared with other children of the same sex and age, 80 percent have a lower BMI.
Cutoff points on these growth charts, established by the Centers for Disease Control and Prevention (CDC), help identify overweight children:
- BMI-for-age between 85th and 95th percentiles — at risk of overweight
- BMI-for-age over 95th percentile — overweight
Because BMI doesn't consider things like being muscular or having a larger-than-average body frame and because growth patterns vary greatly among children, your doctor also factors your child's growth and development into the overall weight assessment. This helps determine whether your child's weight is a health concern.
In addition to BMI and charting weight on the growth charts, the doctor also evaluates:
- Your family's history of obesity and weight-related health problems, such as diabetes
- Your child's eating habits and calorie intake
- Your child's activity level
- Other health conditions your child may have
Next time, we will examine the complications of childhood obesity, as well as review treatment options. This epidemic will rapidly become the main economic drain on our country’s health care system, and we as parents must do all we can to give our children the best shot at a happy, healthy childhood.
Until next time, all the best, in health and life.
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*This article is designed to provide general guidelines only. Please consult with your physician before making dietary changes or beginning an exercise program. |
