Obesity in Children
Obesity is defined as excess body fat. It really is excessive adipose tissue that is due to either an increase in the size of fat cells or an increase in the number of fat cells. Children experience both size and increase in fat cell number throughout the course of their childhood. It is normal and must happen for them to develop into healthy adults. The problem lies in trying not to interfere with normal physiologic changes associated with normal development. Children are not candidates for liposuction, crash diets/fad diets or gastric surgery. Surgery may be performed during late adolescence but it is rare. The primary goal for obese children is not weight loss. The loss of weight is a by product of the main goal. The primary goal is to introduce good interventions that will allow a child and their caregivers to make healthy choices on diet and activity.
Here are some interesting facts regarding obesity:
1. 12.5 million children are obese. That is 17% of the population.
2. 15% of new diabetic cases among children and adolescents are the type 2 kind. Type 2 diabetes is commonly known as adult onset that is related to poor diet and obesity.
3. 73 million adults are obese (how many obese adults were obese children? The answer is plenty).
4. Obese Children are at risk for asthma, diabetes, cardiovascular disease, sleep apnea and emotional health issues. Studies show that cardiovascular disease starts a lot sooner than middle age.
5. There has been a rapid increase in obesity from the 1960’s to the 1990’s. It has tripled from 5% to 15%.
6. In 2008, obesity related costs were estimated to be 147 billion dollars. The amount 10 years earlier (1998) was 78.5 billion dollars.
It is obvious that obesity takes its toll in many ways on our community and our resources.
Obesity is best measured by BMI, which stands for Body Mass Index. BMI compares weight, height and age with the use of growth charts. The Centers of Disease Control and Prevention have developed growth charts that can enable a health care professional to determine were your child stands in relation to his/her weight appropriateness.
1. 5% to 85% is considered within normal limits.
2. 85% to 94% is considered overweight.
3. 95% or greater is considered obesity.
Measurements of skin folds and other types of clinical measurements can be used but a really good indicator is blood pressure. Assuming that the child does not have an underlying pre-existing condition, blood pressure tends to be elevated. Children can reduce their BP more easily than adults when proper interventions are introduced. I like using the phrase proper intervention because it takes into account good life long behaviors that will restore children to an acceptable BMI range. Remember that dieting is not the answer for children. The weight loss that will occur will be a sign of proper intervention and good nutrition.
The journey from birth to adulthood has many paths. The path of obesity can start as early as infancy. Studies show that children introduced to table foods at 4 months of age are at risk for obesity and food allergies. Table foods can be introduced at 6 months of age. Breast fed infants are less likely to have obesity. Breast feeding has been shown to decrease the risk of gastric infections, ear infections and provide good nutrition at a much reduced cost. Breast feeding helps mothers’ loose baby fat from the pregnancy and even decreases certain breast cancers. Studies also show that obese children were likely to be obese preschoolers.
There are ethnic disparities regarding obesity. Apparently being a Hispanic male child or a non-Hispanic Black female can place one at greater risk for obesity. What has changed regarding the lives of American children over the last 40 years? Simply put plenty.
1. Children between the ages of 8-18 yrs of age spend 7.5 hours/day engaged in entertainment media such as TV, computers, IPods, DVD’s just to name a few. These activities are all sedentary in design.
2. While enjoying the previously mentioned diversions, children eat high calorie, high fat and hi salt snacks.
3. Only 1/3 of High school students get the recommended physical activity per day.
4. Genetic factors play a role in fat distribution and body size among other things. If one dies of natural causes, 80% of the cause of death has some genetic predisposition associated with it. You can’t control how to pick your parents but you can control much of your environment.
5. Let’s not forget parents are role models. Many children who are obese have parents with similar weight issues. Your own food choices are bestowed upon your children.
It is by far easier to prevent obesity than to treat it. If you see your child exhibiting many of these behaviors or yourself, it is time to make some changes.
We don’t want to deny growing children the proper nutrients needed to become healthy adults. Fad/crash diets tend to deny children proper nutrition. Here are some strategies that can help the fight against obesity, help maintain proper weight AND foster good nutrition.
1. Increase physical activity. A child needs about 60 minutes a day of play or 30 minutes of active play.
2. Decrease TV and exposure to food marketing. Food advertising is very seductive to children.
3. Make better food choices when planning family meals. Some examples include using 2% milk or low fat if your child is over 2 years of age. Don’t go totally fat free with most of your foods because children need fats to properly function. A plate should have half of its contents be fruits or vegetables. Snack time should be once per day in older children. Toddlers eat frequently and in small amounts but make their choices healthy ones. They will develop a taste for veggies and fruits if they are frequently exposed to these types of foods. Look for nutritional values in foods such as whole grain cereals, iron rich foods and calcium containing choices. Many obese kids are malnourished. Many are anemic because their food choices lack nutrients. These poor choices are called empty calories.
4. Breast Feed infants.
5. Get your school and other communities on board. Demand better school lunch, remove soda and junk food from vending machines. Soda has too much sugar and it inhibits calcium uptake in bones. Petition your school boards to mandate physical education for all students. In Cobb County, elementary and middle school children have required PE but high school students are only required to take 1 semester of PE in 4 years of high school. Yes, you read that correctly. Programs such as before and after school sports are available but not all children can participate in these programs. Reasons such as money, needing rides or babysitting responsibilities may prohibit kids from participating. Both parents work and that makes children more responsible for their own use of time and performing more chores around the house.
6. Walk with your child/children after dinner. You’ll get more than just physical activity from this excursion.
7. Educate yourself using the web with sites like Healthy People 2010, MyPyramid.gov and Let’smove.gov.
8. Always make your goals attainable and reasonable. Frustration can cause a back lash affect.
Most of all, preventing the problem and giving your child a good example is far better than treating obesity. By instilling proper eating habits from young, the stage is set for a lifetime of good nutrition. Overall health will be improved and quite possibly deter certain illnesses. If you are your child are obese, it is never too late to change. Stay well.