The Heavy Toll of Obesity
In our super-sizing culture, it seems that children, too, are getting bigger.
Recent studies of American 2-year olds find that 10 percent are overweight, double the rate from the mid-1970s.
Physicians are seeing an upswing in diseases associated with childhood obesity: the early stages of high cholesterol, hypertension and Type 2 diabetes, commonly mislabeled "adult" diabetes.
"Type 2 diabetes in children was almost unheard of 20 years ago," says Robert Siegel, MD, a pediatrician at St. Luke Pediatric Center in Bellevue, Kentucky. "Now we're seeing it, as well as children in a pre-diabetic state. They are insulin-resistant, and their bodies have to make extra insulin to maintain blood sugar at normal levels."
Such "adult" illnesses have led some researchers to suggest that America's current generation of children may be the first to live shorter lives than their parents.
Charting Obesity
In addition to tracking height and weight, many pediatricians also measure a child's body mass index (BMI). BMI is a formula that uses height and weight to calculate total body fat. Because the body's optimal fat ratio changes with age and is different for boys and girls, BMI charts for 2- to 20-year-olds are ageand gender-specific.
A child with a BMI higher than 85th percentile is considered overweight and at risk for obesity; higher than 95th percentile, obese.
Dr. Siegel is also medical director of the Cincinnati Pediatric Research Group, an association of about 45 physicians who conduct outpatient-based research. During the past two years, the group sampled children in Greater Cincinnati and discovered that by age 8 to 10, 20 percent of children are overweight, and another 24 percent are obese. "These are significantly above the national figures," says Dr. Siegel.
Building Healthy Eating Habits
Pediatricians are now recommending that children 2 years and older eat mostly fruits, vegetables, whole grains, beans, fish, lean meat and low-fat and non-fat dairy products, in keeping with the new governmental food pyramid guidelines. Plus, they urge children to get an hour of exercise a day.
"With our diets, calories have increased while quality has decreased," says Dr. Siegel. "Many of the meals are easy fast food, such as fried chicken bits, french fries and, in Cincinnati, chili dishes – that's fatty meat and cheese on top of a generous portion of carbohydrates."
Instead, he recommends a diet shift to fruits and vegetables – for the entire family. "We must change the quality of the food that children eat at home. They don't go out and buy this junk.
"The whole house has to agree. Everyone can avoid simple sugars, such as white bread or rice, white potatoes, and liquid sugars, such as soda.
"There was an idea that it cost a lot of money to eat healthfully, but fruits and vegetables are still a great deal. Meat is expensive, but you eat less of it. There are even quick, frozen meals that have good portion control for $3 or less. That can be cheaper than fast food," he says.
Get Moving
"Also, children are more sedentary. At our house, we banned TV during the week, and there wasn't the rebellion from my three boys that I thought there'd be. Instead, children need to run around with other children. That's not necessarily at soccer practice, either, which can have a lot of down time."
At Cincinnati Children's Hospital Medical Center, the HeathWorks! weight management program combines gradually increased exercise with behavioral tools for eating a nutritionally balanced diet. It is a family approach, with each member eating a balanced diet. The family then adds stepped-up activity to replace some television and computer time.
"HealthWorks! is a very intensive program that's highly successful," says Dr. Siegel. "Pediatricians are trying to help children prevent the health problems of being a heavy adult."
