Thursday, June 3, 2010

Solving the Problem of Childhood Obesity

One out of every three children in the US is either overweight or obese, according to the White House Task Force on Childhood Obesity. First Lady Michelle Obama launched the Let's Move! campaign to solve the childhood obesity epidemic within a generation.

The goal is to return to a childhood obesity rate of just five percent by 2030, which was the norm before childhood obesity first began to rise in the late 1970s. Let’s Move! presents 70 specific recommendations and urges parents, healthcare professionals, and schools to work together.

“This is a social problem with large-scale proportions,” explains Sam Gidding, MD, Cardiology Division Head of the Nemours Cardiac Center at A.I. Dupont Hospital for Children. The campaign will offer parents the tools, support and information they need to make healthier choices for their families. Dr. Gidding encourages families to examine the recommendations and choose a few things that they can realistically work on.

“A very good goal is weight maintenance,” he says. “Don’t shoot for dramatic weight loss or rash solutions, but get into a regular dietary pattern that allows the child to achieve weight maintenance.”

Costs of Obesity

Childhood obesity leads directly to other health issues in children, including hypertension, Type II diabetes, orthopedic problems, cholesterol and lipid problems, and physical inactivity.

“The costs of obesity are already with us in pediatrics,” points out Dr. Gidding. “Kids aren’t able to participate in athletics at a level that you would normally associate with being young. A lot of kids have asthma and with the obesity epidemic their asthma is much worse than it needs to be.”

Many of these problems are reversible with lifestyle changes if attacked at an early age. “Once you get into your twenties, that’s when the problems will start to become irreversible,” suggests Dr. Gidding. “For the kids who have diabetes, some of the damage isn’t reversible but at least some of the consequences can be prevented. For the garden variety kid, a lot of the stuff can be undone if they get control of their weight.”

Healthier Choices
It’s up to parents to lead by example, to model appropriate lifestyle behaviors, says Charlotte Genetta, Outpatient Dietician for Virtua Centers for Nutrition and Diabetes.

The first step parents should take is to set specific times and places for eating. While it may not happen every night, kids should expect to sit down for a meal without other distractions. “Studies prove that the psychological health of the young child and teen is enhanced by family meal times,” explains Genetta. “This also conditions them to take their time eating.”

She encourages parents to empower their kids to make responsible decisions by giving them choices in what they eat. For example, by creating a family vegetable garden, children can take pride and ownership in what the family is eating. Radishes are a particularly good example because they are fully grown in only three weeks. Parents can also have their kids accompany them to the food store to choose healthy meals, such as fruit to be made into a smoothie.

“You really can’t manage weight effectively without addressing both diet and exercise,” says Genetta. She urges kids to get at least an hour of physical activity every day, yet, many families struggle to find time to fit exercise into their daily routine.

During the summer there are lots of ways kids can be physically active, even if it’s just walking or biking through the neighborhood. When planning vacations, be sure to include physical activities such as swimming or hiking. Even the Wii system has gained popularity for its physical games. Also, try to find active ways to introduce your kids to healthy foods. Strawberry picking or visiting a farm teach children where fresh food comes from which encourages good nutrition.

“Kids model parents,” Genetta says. “If the kids see that mom and dad find exercise enjoyable, they will also view it that way. That’s important. You don’t want them feeling that exercise is akin to homework. It should be pleasurable movement through space. At every age there is something that can be done with movement.”

For severely overweight children, Dr. Gidding points out that exercise should be a weight maintenance strategy, not a weight loss strategy. “They want to get to a point where regular physical activity is part of everyday existence and they have to remember that the importance of exercise is a way to be healthier and be able to achieve weight maintenance,” he says. “But weight loss can’t be achieved without a dramatic reduction in how much the kids are eating.”

Genetta believes that parents should not restrict calories for their children unless the child is above the 95th percentile for their body mass index. Lifestyle changes in diet and exercise will help children grow into their weight. Kids will become more physically toned by losing fat and gaining muscle.

“A lot of kids are way over the 95th percentile,” she points out. “In that case, you have to restrict calories. It depends on the child’s age and how overweight they are.”

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