The 'expansion' of American children is an alarming trend. In addition to posing health concerns, obesity can trigger the start of social problems. Here's what you can do.

 

Near Baton Rouge, Louisiana, a six-year-old first-grade boy tipped the scales at 95 pounds. His ideal weight was no more than 50 pounds. He felt isolated, and was always dead last in gym class, school sports, and games.

Eventually, his physician referred him to the Committed to Kids Pediatric Weight Management program at Louisiana State University in New Orleans. His first prescription slip read: "Play outside twice a week for 20 minutes."

The prescription could be satisfied by walking, bicycling, in-line skating, or other common childhood pastimes. At the beginning, it was tough for him to huff and puff through those 20 minutes. However, he soon worked up to aerobic exercises and other physical activity five times a week for 45 minutes. He, along with his family, also discovered better nutrition habits and reduced his weight to 67.5 pounds in a year. But the big plus for him was constantly placing first in sports at school.

The Expansion of America's Kids

American children are getting fatter, and obesity seems to increase with age. An American Academy of Pediatrics (AAP) study found that while one to three year-olds were rarely obese, by four to five years obesity occurred in 10%. Overall, one in five American children under age 12 are 20% or more over their ideal weight, according to the Centers for Disease Control and Prevention in Atlanta, Georgia. . Experts say childhood obesity is partly caused by kids who are home alone after school and can snack on whatever they want, as often as they want. Additionally, more and more children have become couch potatoes who routinely log six hours a day watching television, videos, and spending time on the computer. The AAP's conclusion? Start healthful eating habits and physical activity early on to prevent school-age kids from becoming overweight.

Getting Kids Moving

Activity is the single most important factor in preventing and treating childhood obesity. Kids need to be active, not just to burn calories, but to establish patterns of physical fitness that will last into healthy adulthood. "We don't tell our young patients they must give up TV," says Uwe Blecker, MD, medical director of the weight loss clinic and associate professor of pediatrics at Louisiana State University. "Just reduce their TV time to three hours daily. Or, we ask them to ride a stationary bike or walk on a treadmill while watching television."

Fighting Fat with Food

Nancy A. Schonefeld-Warden, MD, chief of general pediatrics at the University of California, Davis, Medical Center in Davis, California observes that: "a diet for significantly obese children should include five to eight servings of grains, five to six ounces of lean meat, three servings of vegetables, three to four pieces of fruit, two to three glasses of skim milk and no more than three to five teaspoons of fat."

Dr. Schonefeld-Warden correctly observes that fat intake plays a role in childhood obesity. Studies show that most U.S. kids have a diet in which calories from fat account for 40-45% of the daily total. A cheeseburger with fries, for example, contains as much fat as the maximum that a healthy child should eat in two days! But the body doesn’t care where calories come from when it stores excess food intake as fat. Soft drinks, candy, starches, milk, juices, and fruits all contain large amounts of simple carbohydrates which contribute to excess calorie intake just as much as do fats.

What Happens to Heavy Kids When They Grow Up?

Heavy children risk more widespread health complaints. These include the development of diabetes, hypertension, atherosclerosis, and skeletal problems in the hips and legs.

Additionally, studies reveal that portly children usually grow into overweight teens and adults. Each stage then brings its own health and social complications. But when an overweight child learns to reduce and maintain his weight through good nutrition and exercise, the loss is more likely to be permanent into young adulthood.

A Family Matter

"One of the primary causes of childhood obesity among our patients is because families no longer sit down daily for dinner at a fixed time," says Dr. William Klish, head of pediatric nutrition at Baylor College of Medicine and Texas Children's Hospital in Houston. "Instead, children eat in front of the TV, after 'grazing' all afternoon. But when everybody sits down for dinner every night, fewer and healthier calories are consumed. Also, today's children just don't play outside very much."

Families eat less when they eat together because they talk. That slows down the speed of eating, giving the stomach's fullness signals a chance to work. Even small amounts of food will start sending satiety signals to the brain after about 20 minutes.

Simple Changes

Ideal loss for an overweight child is no more than one-half to one pound per week. "In my practice, I've found that a child can often lose unwanted pounds through some very simple changes," says Marilyn Day, a nutritionist at Children's Hospital in Denver, Colorado. "Some kids just cut back from whole milk to skim milk or cut out the highly sugared cola drinks and lose weight."

Other researchers found an unexpected source of flab in a study group of 168 children ages two to five. The culprit? Fruit juice. Researchers found that children who drink at least 12 ounces of fruit juice daily are more likely to be obese. While parents should be aware of a child’s overall calorie intake, healthy weight management comes from small changes in food and big changes in activity.

Tuning In to Natural Instincts

 

A study by Leanne L. Birch, PhD, professor and head of the department of human development and family studies in the College of Health and Human Development at Pennsylvania State University in University Park shows that while Jimmy may turn up his nose the first, second, or even the third time he tries a new food, he may gleefully wolf that same food down the eighth or tenth time the dish is set before him. Patient parents may assist their children in eventually adopting the best eating habits. Dr. Birch also found that when children were not expected to finish all the food on their plate, they were able to effectively use appetite to regulate their own caloric intake.These studies suggest that children’s tastes may develop at their own appropriate pace, and that children’s appetites often reflect their actual needs "Unfortunately, some well-intentioned mothers are producing effects exactly opposite of what they hope to see," says Dr. Birch. "The struggle for power undermines the child's ability to develop self-control."

So patience and gentle persistence may be the answer for caregivers trying to make vegetables and other unfamiliar but healthy dinner fare more popular with young children. After all, if it leads to better health and an appropriate weight, what are a few servings, more or less, of peas and spinach on your dining room floor?

Resources

Fun fitness and low-fat eats for kids.

"Parental Control and Children's Eating," by S.L. Johnson and L.L. Birch. Pediatrics, Vol. 84, No. 5, 1995, pp. 653-661.

"Morbidity and mortality association with elevated body weight in children and adolescents," by A. Must. American Journal of Clinical Nutrition, Vol. 63, 1996, pp. 445S-447S.

"Do obese children become obese adults? A review of the literature," by M.K. Serdula, et al. Preventive Medicine, Vol. 22, 1993, pp. 167-77.

"Overweight prevalence and trends for children and adolescents: the National Health and Nutrition Examination Surveys, 1963 to 1991," by R.P. Troiano, et al. Archives of Pediatric and Adolescent Medicine, Vol. 149, 1995, pp. 1085-1091.

ThirdAge WWW