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Decreases in Childhood Obesity

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Rates of childhood obesity have risen for decades in the U.S., and there are many reasons why its prevention and treatment ought to be a focus of public policy. For one, preschoolers who are overweight or obese are five times more likely than normal-weight preschoolers to have weight problems during adulthood. And one preschooler in eight is obese, with higher rates among some racial minorities.

Recently, the Centers for Disease Control and Prevention (CDC) found encouraging evidence that these trends might be improving. In a study of 11.6 million low-income preschoolers, the CDC found a small decrease in childhood obesity rates in 19 U.S. states and territories from 2008 to 2011. Experts attribute the good news partially to programs that encourage child exercise, an increase in breast-feeding, and improved nutrition in foods provided to low-income families through federal programs. This research suggests that the problem of childhood obesity can be ameliorated.

In the Future of Children, Ana C. Lindsay, Katarina M. Sussner, Juhee Kim, and Steven Gortmaker argue that successful interventions must involve parents from the earliest developmental stages to promote healthful practices in and outside the home. Regarding the racial and economic disparity in childhood obesity rates, Shiriki Kumanyika and Sonya Grier observe that low-income and minority children tend to watch more television than do white, non-poor children and are potentially exposed to more commercials advertising unhealthy foods. One strategy would be for Congress and the Federal Communications Commission to reduce or eliminate advertising time for non-nutritious foods aimed at children. For more recommendations on how to promote childhood health, see the Future of Children issue on Childhood Obesity.

Involving Parents in Childhood Obesity

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Obesity levels have more than doubled among children and tripled among teens in the past three decades. Today, CDC estimates that 12.5 million kids are obese - nearly 17 percent of children and adolescents in the US. Future of Children author Stephen R. Daniels reports that obesity has serious consequences for children and teens, including health conditions that were previously considered adult-only issues: high blood pressure, nonalcoholic fatty liver disease, hardening of the arteries, and type 2 diabetes, to name a few.

 

In the Future of Children, author Christina Paxson and colleagues explain that that while researchers have proposed many environmental and policy solutions to the obesity problem, such as regulating the sale of soda in schools or building more sidewalks, several strategies are more promising for the short term. These include in-school, after-school, and child-care initiatives, as well as improving pediatric care. The most effective strategies will involve parents, who play a significant role in obesity prevention from gestation and infancy through adolescence.

 

Time Magazine recently highlighted a five-month intervention program in which parents and children learned about healthy eating and exercise, and parents learned how to set limits and teach their children to monitor their own eating. In addition, these families met for 20 minutes with their physician every two weeks to be weighed and receive advice and reading material. Results showed significant weight loss in the treatment group, while the control group continued to gain weight.

 

Future of Children author Ana C. Lindsay and colleagues explain, "By better understanding their own role in influencing their child's dietary practices, physical activity, sedentary behaviors, and ultimately weight status, parents can learn how to create a healthful nutrition environment in their home, provide opportunities for physical activity, discourage sedentary behaviors such as TV viewing, and serve as role models themselves." For more information on research-based childhood obesity intervention, see the Future of Children issue on Childhood Obesity.

Speaking with Children about Obesity

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The childhood obesity crisis has been in the news for many months now. We know that obese children face certain difficulties with health in adulthood. Heart disease, high blood pressure, hardening of the arteries, type 2 diabetes, metabolic syndrome, high cholesterol, asthma, sleep disorders, liver disease, orthopedic complications, and mental health problems are just some of the health complications of carrying excess weight. (Future of Children, Childhood Obesity).

 

Despite all the public attention and concern, policymakers are uncertain how best to combat childhood obesity. Researchers have identified many possible causes of the obesity epidemic, but the research base on how to prevent obesity is still limited, making it difficult to decide how best to proceed. With state and federal budgets already strained, it is important to develop programs and policies that are effective and can be implemented at reasonable cost. Parents play an important role in these efforts.

 

In a recent article "Talking to your Kids About Weight Loss," Chris Iliades, writes that "in a country where 17 percent of all children are obese and another 17 percent are overweight, childhood obesity should be a topic of conversation for families. But according to a recent study published in the journal Pediatrics, how we talk about childhood obesity could be just as important as whether we're talking about it. According to the study, 36 percent of parents would react to words like "fat" and "obesity" by putting their child on a strict diet and another 35 percent would go off in search of a different doctor -- and neither of these reactions are best for a child's health.." 

 

As the authors of the Future of Children's Childhood Obesity chapter, "The Role of Parents in Preventing Childhood Obesity," caution, "even though childhood obesity experts discourage dieting, parents who feel the need to control a child's weight commonly encourage dieting. Studies on dieting behaviors consistently report that their parents' inducement to diet is the most significant factor in causing children to begin dieting. Their parents' direct verbal encouragement is more influential than the parents' own dieting behaviors. Many adolescents whose parents urged them to diet report engaging in unhealthful dieting behaviors. Focusing on dieting for weight control may overemphasize the thinness ideal and over time may even lead to an increased risk for obesity. It is important for parents of overweight children to learn about the dangers of dieting and to talk with their child's doctor or health care provider about ways to promote healthful habits." (to view the source for this quote, please see page1 75 of this article.)

 

The authors conclude that "parents play a critical role at home in preventing childhood obesity, with their role changing at different stages of their child's development. By better understanding their own role in influencing their child's dietary practices...parents can learn how to create a healthful nutrition environment in their home, provide opportunities for physical activity, discourage sedentary behaviors such as TV viewing, and serve as role models themselves." 

 

To read more about parents' role in preventing childhood obesity, please visit the Future of Children website  and the journal on Childhood Obesity

Physical Activity Promotes Health in Mind and Body

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Anti-obesity ads in Georgia (Strong4life), featuring overweight, unhappy children, have caused much controversy. The ads are aimed at awakening parents to the stark reality of obesity with such messages as "Some diseases aren't just for adults anymore," and "Being fat takes the fun out of being a kid." While the ads do a great job of pointing out the problem, Dr. Lori Feldman-Winter, a pediatrics professor at the Robert Wood Johnson Medical School points out that "There is no mention about what a parent can do other than to say 'stop sugarcoating the problem'."  There is also a worry that the ads will create self-confidence problems for overweight children.  Dr. Miriam Labbok states, "Blaming the victim rarely helps. These children know they are fat, and they are ostracized already."  (NY Daily News January 2, 2012.)

The Obesity Coalition is among those who oppose the ads, writing in a letter to Georgia Children's Healthcare Alliance that the "messaging of the campaign is purely fuel for the fires that represent the nonstop onslaught of teasing and bullying that America's children, affected by childhood obesity, face daily." Yet Maya Walters, a teenager who appeared in one of the ads states "I think it's really brave to talk about the elephant in the room.  It's very provocative and makes people uncomfortable, but it's when people are uncomfortable that change comes." (NY Times Motherload Blog January 3, 2012)

Teaching kids to make healthy food choices and encouraging physical activity can help kids avoid obesity.  According to a recent research study published in the journal Archives of Pediatrics and Adolescent Medicine, "While physical activity is known to improve children's physical fitness and lower their risk of obesity, new research suggests that it may also help them perform better in school."  The Centers for Disease Control and Prevention also found that out of 50 studies, more than half showed a positive association between school-based physical activity and academic performance.  ( ABC Good Morning America, January 2, 2012)

Another study by Dr. Kristen Copeland from Cincinnati Children's Hospital Medical Center in Ohio, published in Pediatrics shows that "daily physical activity is essential for preschool age children both for preventing obesity and for their development- their physical development and their cognitive development...When kids are running, skipping and learning to ride tricycles, they aren't only exercising their bodies, they're also exercising their minds."  Copeland suggests that parents get involved to help shape child care practices around physical activity. (thechart.blogs.cnn.com)

The Future of Children journal on Childhood Obesity suggests the following:

·         Involve both children and parents in obesity-prevention programs, typically conducted within schools, child care centers, and after school programs.

·         Improve nutritional and physical activity standards within schools.

·         Limit children's exposure to advertising.

·         Improve preventive care and treatment for obesity and related conditions.

For further reading about obesity in children, please visit the Future of Children.

Childhood Obesity

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First Lady Michelle Obama has made reducing childhood obesity a priority and has instituted the Let's Move program. "Let's Move is about kids eating healthy and moving and staying active, so you all are ready for life and for all the challenges that you're going to face," she said in the Let's Move Blog, which reported the First Lady's October 12th South Lawn event aimed at breaking the Guinness Book of World Record for the most people doing jumping jacks in a 24-hour period.

 

Childhood obesity continues to be a serious problem in the United States. Between 1971 and 1974, just 5 percent of all children were considered obese. The percentage of obese children doubled by 1994 and tripled by 2002 according to Future of Children authors, Patricia Anderson and Kristin Butcher's calculations from the National Health and Nutrition Examination Surveys.

 

"Logically enough, increasing childhood obesity is related to increasing adult obesity. Obese children are much more likely than normal weight children to become obese adults. Obesity even in very young children is correlated with higher rates of obesity in adulthood. A study from the late 1990s shows that 52 percent of children who are obese between the ages of three and six are obese at age twenty-five as against only 12 percent of normal and underweight three- to six-year-old children." (Future of Children: Childhood Obesity)

 

Theories about what caused the obesity epidemic in the US abound. Some of the factors include: increased television and computer/video game usage, increasing use of fast-food restaurants, marketing of sugary and fat-laden foods to children, schools that offer junk food and soda to children, scaled back physical education classes and recess, and working parents who are unable to find the time or energy to cook a nutritious meal or supervise outdoor playtime. There has also been an exodus of grocery stores from urban shopping centers. This makes affordable fresh fruits and vegetables scarce.

 

But why should we care about childhood obesity? Shouldn't we look beyond the physical and love children as they are? While the causes of childhood obesity can be debated by many, the consequences cannot. Obesity causes many health problems: heart disease, high blood pressure, hardening of the arteries, type 2 diabetes, metabolic syndrome, high cholesterol, asthma, sleep disorder, liver disease, orthopedic complications and mental health problems, just to name a few. "The possibility has even been raised that given the increasing prevalence of severe childhood obesity, children today may live less healthy and shorter lives than their parents." (Future of Children: Childhood Obesity)

 

Reducing obesity requires changes in behaviors surrounding eating and physical activity. Children don't control their environments and have difficulty making healthy choices around food. There is a clear rationale for modifying children's environments to make it easier for them to be physically active and to make healthful food choices, thus reducing their chances of becoming obese.

 

On Thursday, October 20th, news sources across the country reported new research by Future of Children author and University of Chicago professor Jens Ludwig, which  found that "low-income women with children who move from high-poverty to lower-poverty neighborhoods experience notable long-term improvements in some aspects of their health, namely reductions in diabetes and extreme obesity." The Future of Children journal on "Childhood Obesity," addresses several broad domains of children's environments--the market place, the built environment, schools, child care providers, and homes--that might be modified to reduce obesity.

 

The Future of Children: Childhood Obesity can be read free of charge on our website.

 

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