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A Weighty Issue: Childhood Obesity
At one time, an overweight child was more the exception than the rule. But these days, the number of obese children in the United States is increasing at an alarming rate.
According to a 2006 report from the National Center for Health Statistics (NCHS), the United States has the highest prevalence of obesity among developed nations. The percentage of young Americans who are overweight has more than tripled since 1980. Among children and teens ages 2 to 19 years, 17 percent of young people are considered overweight.
Up to 80 percent of children who are obese remain overweight as adults, according to the National Institutes of Health (NIH). Childhood obesity is more prevalent in the Northeast, followed by the Midwest, South and West. It is also more prevalent in cities than in rural areas.
The determination of childhood obesity is more than the numbers on a scale. Nutritional experts rely on body mass index (BMI) to estimate body fat and the degree of overweight or obesity. BMI is a mathematical formula that uses a person's height and weight. Cutoffs to determine normal, overweight and obese weight in children are based on BMI-for-age growth charts. Children with BMI values at or above the 95th percentile are considered overweight.
Too little exercise, too much junk food
Although overweight and obesity in adults and children stem from eating more calories than are used up in physical activity, the issue involves a complex interaction between lifestyle, environment and genes. The rise in childhood obesity can be tied to two factors: too little exercise and too many calories. Children get less exercise at home because of more time spent with television, video games and computers, and they get less exercise at school because many schools have cut back on physical education classes.
In addition, time-strapped families end up eating more meals at fast-food restaurants or buying take-out food--choices that often include foods high in calories and fat and large portion sizes. Many schools also include franchised fast-food menu choices for lunch, as well as soft drink and candy machines for snacks. Under public pressure, some schools have begun stocking vending machines with healthier choices, such as fresh fruit and fruit juices.
Genetics and race also play a role in who ultimately will become overweight or obese. Children of overweight parents are at a greater risk for obesity themselves, and recent studies have found over two-thirds of American adults are either overweight or obese. More Mexican American and non-Hispanic black girls than non-Hispanic white girls are overweight. More Mexican American boys than non-Hispanic black or white boys are overweight, according to NCHS.
Although excess weight can harm a child's self-esteem--few kids like the nicknames "tubbo" and "fatty"--the physical damage is just as bad. Many children who are obese already have high cholesterol, high blood pressure, abnormal glucose tolerance or a combination of these conditions. Any one of these increase a child's later risk for heart disease and diabetes, according to the Centers for Disease Control and Prevention.
Sleep apnea can be a serious problem for obese children, according to the NIH. Sleep apnea is a sleep disorder in which a person's breathing is interrupted many times during the night. Sleep apnea can cause learning and memory problems in children.
Obese children, particularly girls, also are at risk for liver problems, hypertension, endocrine imbalance, gallbladder disease and stress-induced joint disease. Obese children also are more likely to have asthma.
Turn it around
Preventing obesity in children requires helping them increase their physical activity and decrease the number of calories they eat. Children should exercise every day and eat foods high in fiber and low in calories and fat.
Parents can help by buying fruit, vegetables and other low-fat foods and serving their children kid-sized portions, instead of stopping at fast-food restaurants. Signing up children for team sports such as soccer, basketball and swimming can keep them active--and burning calories--year-round.
One way to get your children moving is to get the entire family involved in regular physical outings. You can walk or bike together, and plan family vacations that focus on staying active rather than sitting on a beach. When looking for activities, choose those that won't be difficult or embarrassing for your children.
More suggestions for parents
Here are additional tips from the NIH on preventing childhood obesity:
If your child has a weight problem, be supportive rather than critical. Encourage good health habits.
Limit the amount of time your child can watch television, play video games or use a computer. Enforce that limit.
Mealtime should be spent around the table, not in front of the television. Make it an enjoyable, unhurried time.
Food should not be used as a reward or punishment. If you believe that your child should be on a diet, discuss it with your child's health care provider and nutritionist. Offer healthy snacks, including fruits and vegetables; low-fat cheese or plain yogurt; and cookies such as fig bars, graham crackers, gingersnaps or vanilla wafers. Limit the amounts because even healthier foods in large quantities can cause obesity.
Parents may have to completely revamp what and how they cook and plan meals so that meals are higher in nutrition, lower in calories and still satisfying. This may mean switching to foods that require more frequent shopping, such as fresh fruits and vegetables, and longer preparation time.
The entire family should limit sedentary activities, such as TV watching and computer time, and everyone should make exercise part of every day. An active lifestyle for everyone will make it more acceptable to children.
Online ResourcesAmerican Obesity Association http://obesity1.tempdomainname.com/subs/childhood/
American Academy of Pediatrics http://www.healthychildren.org/english/health-issues/conditions/obesity/pages/childhood-obesity-common-misconceptions.aspx
Definition; epidemiology; and etiology of obesit y in children and adolescents, UpToDate http://www.uptodate.com