June 27, 2008

Childhood Obesity

By Chris Larson

Since 1980, obesity among children and adolescents in the United States has increased dramatically, and, most disturbingly, the heaviest children have become even heavier over that time period.

The National Library of Medicine defines obesity as having too much body fat, which is one way of being overweight, where extra mass can come from bone, muscle, or fat. Both conditions arise when a person’s weight is greater than what is considered healthy for their height.

The US Centers for Disease Control has catalogued a substantial increase in obesity in the United States from 1985 until 2006. In 2006, 46 of the 50 states had a prevalence of obesity greater than 20%, 22 states had a prevalence of at least 25%, and fully one third of the citizens of West Virginia and Mississippi are obese.

Being obese significantly increases a person’s risk of developing diabetes, heart disease, stroke, arthritis, and even some cancers, and losing from 5 to 10 percent of their body weight can reduce the likelihood of an obese person developing these diseases.

US children and adolescents have become obese along with the population in general, and scientists now caution that the current generation of young people could be the first generation in history whose life expectancy will be shorter than that of previous generations.

What can be done to address this mounting public health crisis? Recent medical research suggests several remedies for obese adults and children alike.

Obesity occurs when, over time, more calories are eaten than used. The balance between the ingestion and burning of calories is different for each person, and is affected not only by general overeating, but also by eating high-calorie foods such as foods high in fat, not being physically active, and by a person’s genetic makeup. However, most obese persons simply eat substantially more food than their body needs, and the excess calories are stored as fat.

The obvious approaches to the problem of childhood obesity are thus increasing calories burned, decreasing calories consumed, or both.

A study published in 2008 in the Archives of Pediatrics and Adolescent Medicine described a 6 month program that resulted in greater decreases in BMI at 3 and 6 months for those obese 4th and 5th grade children who participated in after-school team soccer versus similar children who merely received health education. While not surprising, this result again demonstrates the importance of increased physical activity for obese children.

Another study published in 2008 in the same journal found that reducing television viewing and computer use had a significant effect in preventing obesity and lowering BMI in children, and by measuring both energy intake and physical activity made the important observation that lowering energy intake played an even greater role than changes in physical activity in achieving these health goals.

Not only the quantity of food, but the type of food ingested can play a role in the development of obesity. Dietary fat is very high in calories, and eating a high-fat diet predisposes children and adults alike to obesity, as do foods and beverages high in sugar. Surprising, the low-calorie sweeteners favored by many individuals trying to maintain or lose weight probably offer little benefit, and paradoxically may even promote weight gain.

A 2007 review in the European Journal of Clinical Nutrition of many medical and scientific studies found no clear benefit of sugar substitutes on bodyweight. And several studies noted within that review suggested that low-calorie sweeteners may even increase a person’s appetite for sweet foods, thereby leading to overeating and weight gain.

How do you know if your child is actually obese, or is at risk of becoming so? As parents know, children grow at different rates, so at any point in time it may not be obvious that a child is obese or overweight. The wisest course is to ask your doctor or school nurse to measure your child’s height and weight to determine if he or she is in a healthy range. If a weigh-loss program is indicated, encourage the entire family to adopt healthy habits so your child doesn’t feel isolated or singled out.

Healthier eating can be achieved by serving more fruits and vegetables and minimizing sodas and high-calorie, high-fat snack foods. Increased physical activity will also help your child prevent or reverse obesity, with most doctors recommending that children participate in 60 minutes of moderate physical activity daily. Your child may protest now, but their older, thinner, healthier version will thank you for the good lifestyle habits you encouraged early.

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