Out of proportion
Childhood obesity is a growing problem in the United States
By Marisa Osorio Colon
NYT Regional Newspapers
TIPS TO FIGHT CHILDHOOD OBESITY
The National Academies of Sciences Institute of Medicine recently released a report, “Preventing Childhood Obesity: Health in the Balance,” and a series of committee recommendations on how to combat childhood obesity.
Here are the changes the report recommends in your household:
Encourage children to develop a healthy, varied diet by introducing new foods in a persistent but non-coercive fashion. Studies show that it can take five to 10 exposures to a new food before a child will accept it.
Consider smaller portion sizes, allow children to stop eating when they feel full, and avoid using food as a reward.
Stock your home with healthy products, particularly fruits and vegetables, to promote them as snack choices for your kids.
Have your children avoid sodas and other high-calorie, low-nutrient beverages because of concerns about excessive consumption of "empty calories." — Make physical activity a regular part of children’s lives; limit TV watching.
The report adds these national policy recommendations as well:
Health insurers and health plans should make childhood obesity prevention a priority, including screening and obesity prevention services in routine clinical practice.
Pediatricians, family physicians, nurses, and other health care providers should actively discuss their patients’ weight and body mass index (BMI) with both parents and children.
The U.S. Department of Health and Human Services should convene a national conference of industry, business, and public health representatives to establish standards for marketing foods, beverages and sedentary entertainment.
Children in the United States are getting fatter.
So fat, in fact, that some say childhood obesity has become a national epidemic.
“This will be the first generation that has a lower life expectancy than their parents,” said Dr. Fred Pescatore, a physician and author of “Feed Your Kids Well” (Wiley, $14.95).
Over the past three decades, the obesity rate has more than doubled for both preschoolers and adolescents — and has more than tripled for children 6 to 11 years old, according figures from the Washington, D.C. -based National Academies of Sciences Institute of Medicine.
Today, about 9 million American children ages 6 and older are considered obese, when excess body fat puts a person at a high health risk. Some experts have even taken to calling childhood obesity a public-health emergency and a problem that needs to be addressed immediately.
If not, they say, the result will be billions of dollars spent on health care, as well as lost worker productivity related to life-threatening diseases — including type 2 diabetes, high blood pressure, kidney failure, heart disease and depression — that will start in early adulthood.
The extreme measures that many adults take in their personal battles against being overweight — everything from liposuction to stomach stapling — have been widely reported.
But “surgery isn’t an option for a 90-pound 4-year-old,” said Dr. Adam Aponte, a pediatrician and medical director of the Diagnostic and Treatment Center at North General Hospital in New York City. “Even if we can’t get these kids to lose weight, if we can just maintain that weight until they are 5 or 6 or 7 years old, they will be in better shape.”
Part of the problem in treating obesity in children is that insurance companies will not always reimburse physicians for treatments or referrals, Aponte said. Sometimes it might be a case of the family not having health insurance at all. In an effort to fight childhood obesity, North General recently partnered with HMO Affinity Health Partners to create a program for overweight and obese children. The program offers a nutritionist and an opportunity for safe exercise — an option not always available in certain areas, especially low-income or high-crime neighborhoods.
Nudging children into motion is a step in the right direction.
“We as parents need to expect kids to be more active,” said Dianne Ward, professor of nutrition at the University of North Carolina at Chapel Hill. “I think we’re very dutiful about making sure they do their homework and accomplish academically, but we have to make sure the lifestyle of the child has activity woven into it.”
Parental involvement is key, agrees Lisa Altshuler, director of pediatric behavioral psychology at Maimonides Medical Center in Brooklyn, N.Y., who counsels her patients about portion sizes, making better food choices and becoming aware when their body is telling them that they are hungry.
"Our portions have gotten bigger, and we’re not moving," Altshuler said. “Our program focuses in on small changes people can make over time. We do see an amazing turn around when we get parents and children involved.”
Local government could also provide solutions. In North Carolina, Ward said, the state recommends that more physical education be provided and health-advisory groups created — the type of suggestions that appear to be making the rounds.
In September, the Institute of Medicine released a report called “Preventing Childhood Obesity: Health in the Balance,” as well as a series of committee recommendations on how to combat childhood obesity.
According to the report, the food and beverage industries spend $10 billion to $12 billion annually marketing directly to children and youth. The average child views more than 40,000 TV commercials each year — and more than half of those ads promote high-calorie foods and beverages such as candy, snack foods, fast foods, soft drinks and sweetened breakfast cereals. In addition, the entertainment industry promotes many products that encourage sedentary behaviors.
“I think it should be illegal to advertise to kids,” said Pescatore, who believes the government should be subsidizing healthful foods such as fruits and vegetables to make them more affordable. “Being overweight is the second leading cause of preventable deaths after tobacco related illnesses. Why shouldn’t we ostracize foods that have low or no nutritional value, the same way we have ostracized tobacco?”
While research suggests that long-term exposure to these ads might affect kids’ eating habits and activity levels, the report states that there’s not enough hard evidence to support calling for a ban on food-and-beverage advertising to children. Instead, the committee recommended an approach similar to controlling alcohol advertising.
But Dr. Susan Okie, a Maryland doctor and author of the new book
“Fed Up! Winning the War Against Childhood Obesity” (Joseph Henry Press, $27.95), said she was disappointed that the committee didn’t take a stronger stand on industries’ marketing to children.
“We have to get to the bottom of what’s going on here,” Okie said. “We have to turn it around. There really has to be a shift in the education of parents and people who care about kids — so there will be a public outcry.”
(Marisa Osorio Colon writes for the New York Times Regional Newspapers.)