The Childhood Obesity Solution?

eye-closeup

The National Institutes of Health website mentions an interesting 2014 pilot study that “adopts a systems theory perspective to explore associations between parent and child factors and children’s body mass index (BMI).” The object was to find out what kinds of family-wide intervention strategies might help to lower the risk of obesity in high-risk children.

The subjects were 40 Head Start-eligible kids and their mothers, and the researchers looked into such areas as demographic risk, maternal depression, negative parenting, and children’s impulsivity. The “Abstract” says:

Mothers who reported greater demographic risk and more depressive symptoms showed higher rates of negative parenting. In turn, more negative parenting predicted higher child impulsivity ratings, which were related to higher food approach scores. Finally, children who scored higher in food approach had higher BMIs.

Regarding obesity, demographic risk factors are age, gender, race/ethnicity, genetics, and family history. Age, gender, race/ethnicity and genetics are all objectively provable, which leaves family history as just about the only area in which mothers might be expected to report. A family history of obesity is connected with depressive symptoms, and the combination of those seems to promote negative parenting. (Unless the researchers undertook some form of pervasive and intrusive surveillance, the negative parenting would also have to be self-reported, which would be problematic in itself.)

What is negative parenting? The kind that doesn’t work, and leads to bad results rather than good ones. Negative parenting styles include neglectful, permissive, and authoritarian. (The ideal parenting style is considered to be “authoritative” which is very different from authoritarian.)

So, negative parenting causes children to become impulsive, and impulsivity is related to “higher food approach scores.” What does that mean? Claudia M E Hunot writes:

Food approach traits, such as “food responsiveness”, are associated with a larger appetite or greater interest in food, while food avoidance traits such as “satiety responsiveness” are associated with a smaller appetite and/or a lower interest in food. Research has shown higher scores on food approach traits and lower scores on food avoidance traits are associated with increased weight and weight gain.

A very recent study, titled “Food Approach and Food Avoidance in Young Children: Relation with Reward Sensitivity and Punishment Sensitivity,” was set out to explore the hypothesis that “individual differences in Reward Sensitivity and Punishment Sensitivity may determine how children respond to food.” The “Introduction” states:

In the current study, eating behaviors and thoughts that involve a movement toward or desire for food are labeled as Food Approach (e.g., overeating, emotional eating, external eating, eating in the absence of hunger, enjoyment of food), while eating behaviors that involve a movement away from food are labeled as Food Avoidance (e.g., food neophobia, picky/fussy eating, slowness in eating, emotional undereating).

To return to the demographic risk factors, it appears that both family history of obesity and maternal depression are associated with negative parenting, which is associated with child impulsivity, which is associated with a higher food approach score, which is associated with weight gain. Family history can’t be changed, so it seems that the only factor left to work with is maternal depression.

Is this the secret to ending childhood obesity? If so, the prognosis is grim. What intervention strategy could lift the depression that afflicts millions of mothers worldwide?

Your responses and feedback are welcome!

Source: “Psychosocial pathways to childhood obesity: a pilot study involving a high risk preschool sample,” PubMed.gov, December 2014
Source: “Child Obesity Brief,” SanDiegoCounty.gov, undated
Source: “Types of Parenting Styles and How to Identify Yours,” Vanderbilt.edu, 12/10/13
Source: “Measuring appetitive traits in adults. What do we know about their relationships to weight,” UCL.ac.uk, 07/06/16
Source: “Food Approach and Food Avoidance in Young Children: Relation with Reward Sensitivity and Punishment Sensitivity,” NIH.gov, June 2016
Photo credit: Helen Harrop (creating in the dark) via Visualhunt/CC BY-SA

Informal Science Makes a Difference

salad-bar

A couple of years back, the Today show collaborated on an experiment with Brian Wansink, a Cornell University professor who had previously been executive director of the Center for Nutrition Policy and Promotion, a division of the U.S. Department of Agriculture. To prove his point that the sensation of fullness can be engineered, they offered a TV audience a free buffet.

The subjects of the experiment were divided into two groups of 12 each. Jeff Rossen and Josh Davis wrote:

For the first group, the buffet was laid out with fruit and salad first, then fatty pasta dishes at the end. The first group was given normal size plates and normal serving spoons.

[For the second group…] The order of the food was switched so that the healthy stuff went in back while the fatty stuff was placed at the beginning. In addition, group two was given slightly bigger plates and serving spoons. But the food itself was exactly the same.

The first group loaded up with the items they saw first, the healthful offerings, and left little space on their plates for high-calorie pasta. The second group, encountering the pasta first, took more of that.

Prof. Wansink summarized:

The first food you see in a buffet is a trigger food… What we find is, about 70 percent of what people are taking are the first three foods they see.

The second group of subjects, with the larger plates and spoons, averaged around 1,500 calories worth of pasta per person, while the smaller-plate group kept their pasta consumption down to around 890 calories. Also, the large-plate group ate about one and a half times as much total food as their small-plate counterparts. Apparently, humans are subconsciously imprinted with the conviction that a plate must be full.

The message is to use smaller plates and serve healthier foods first. By the time Today did their televised experiment, some American schools were already trying new methods of presenting and serving in their cafeterias.

By applying to school lunches the science of behavioral economics as advocated by Prof. Wansink, administrators were able to increase the consumption of salads. All they had to do was rearrange the physical environment so the salad bar was encountered first.

Fruit consumption was increased by placing it, rather than chips and desserts, in the checkout line. The researchers learned that keeping the lid of the ice cream freezer shut would cut ice-cream sales in half. Students still had a choice about what to eat, but making the high-calorie, low-nutrition items less visible and less convenient makes a noticeable difference in eating habits at school.

The take-home message

The obvious lesson for parents is to do the same at home. If the kitchen must contain snack items, put them away inside cabinets so the temptation doesn’t jump up, multiple times per day, and hit people in the face. At mealtime, serve the healthier items first, and, as for the rest, don’t leave serving dishes on the table.

Make it just a tiny bit inconvenient to take a second helping of high-calorie dishes. Use smaller dinner plates and spoons. Stash ice cream it the back of the freezer, behind and underneath other things, to make it just a bit harder to access. All these little “tricks” can add up, making the path to obesity avoidance a little smoother.

Your responses and feedback are welcome!

Source: “Experts say you can trick your mind into helping you lose weight,” Today.com, 04/22/14
Photo credit: Natalie Maynor via Visualhunt/CC BY

Angles on Therapy

sad-girl

The previous post left off with the Head Start Trauma Smart program, which can help a child who needs to calm down. David Bornstein describes one of the practices — wearing a special bracelet. When a child starts to lose control, the idea is to remember to look at the bracelet and associate it with calming techniques such as, “Stop, take a deep breath, count to four, give yourself a hug and, if necessary, ask an adult for help.”

One suggestion is to have a safe spot, or calm-down corner, “with shoeboxes filled with sunglasses, pinwheels and tactile things: nail brushes with soft bristles, bendy Gumby animals, or pieces of burlap or velvet.” This also sounds like a very good idea for distracting a child who is having a snack-refusal meltdown.

Bornstein gives the example of a five-year-old boy, the child of drug-impaired parents (including a father in prison), who was being raised by his grandparents. The boy’s problems, which ordinarily would have kept him out of preschool, included explosive rage and combativeness. The journalist quotes the grandmother as saying, “We used to have to do these steps four or five times a day. Now we’re down to four or five times a week.”

Head Start Trauma Smart is based on ARC, which stands for “Attachment, Self-Regulation and Competency.” This modality is described as a framework for intervention to deal with multiple and/or prolonged traumatic stress. It’s all about resiliency.

The ability to bounce back from setbacks and even injuries is a prime survival skill. It is the main component of the mysterious quality known as hardiness. People used to think it had to be inborn, or acquired via the “school of hard knocks,” but now we have learned that hardiness can be not only cultivated, but taught.

That is the mission of ARC, whose literature brings up such solemn and fraught issues as “reduced use of restraints in programs, and improved permanency rates in foster care.” If this all seems to be drifting far afield from the topic of childhood obesity, it’s not. Some children live in cars, see parents arrested, face daily humiliation at school because they only have one set of clothes, and may even be physically abused.

For other kids, the worst thing that happens is that they fall asleep listening to their parents arguing, night after night after night. Compared to the first set of circumstances, the second scenario seems pretty lightweight.

But both are traumatizing, and both of those kids might react by wetting the bed, or cutting little slices in themselves. Both might react by eating everything that doesn’t run away first. In other words, any therapy that can help a child with a devastating amount of damage can probably benefit a child with problems that appear, from the outside, to be less stressful.

But because everyone isn’t the same, different approaches sometimes work with different patients. In the quest to alleviate obesity and all its attendant problems, it is advantageous to look at any promising avenue.

Your responses and feedback are welcome!

Source: “Teaching Children to Calm Themselves,” NYTimes.com, 03/19/14
Source: “Attachment, Regulation and Competency (ARC),” TraumaCenter.org, undated
Image by theUdodelig

Some Therapies

mask-man

In the effort to reverse the childhood obesity trend, many experts believe that treatment must be family-based and must include, along with education about nutrition and exercise, training in behavior modification. Usually this would involve the parents and kids attending weekly hour-and-a-half sessions.

It’s good to know that family participation is essential, but along with that knowledge comes a big problem. For many parents, because of economic, geographical, and work-commitment conflicts clinic-based programs are just too much to deal with.

In early 2013 a study from the San Diego School of Medicine showed that a self-help program, as long as it is guided by clinicians, can work quite well. In fact it is claimed that this “low-intensity” study was the first to demonstrate that self-help programs could be successful.

The leader of the National Institutes of Health-funded study was Kerri Boutelle, Ph.D., whose expertise is in pediatrics and psychiatry. The subjects were 50 children ages 8-12, either overweight or obese. The family would receive a manual, with instructions to read a chapter each week at home, and work on implementing the described skills.

They would come to the clinic only once every two weeks, for a brief (20-minute) meeting with an interventionist. According to the press release:

The results of the guided, self-help intervention program showed a significant decrease in BMI immediately after completing the 5-month treatment, losses that were maintained six months later.

“Maintained six months later” are the key words, because we hear distressing reports about fat camps and residential programs, and even about surgical procedures. It seems to be rare for a child to keep the weight off, once she or he is released back into familiar surroundings and normal routine — not to mention, the same family members and friends. It seems, too, that more longitudinal studies are needed, and the problem with them is that no matter how many resources are thrown into the project a 5-year or 20-year study can’t be hurried along.

In the following year, David Bornstein described a similar program for The New York Times. Known as Head Start Trauma Smart, and based on an “intervention framework known as ARC (Attachment, Self-Regulation and Competency)” it was developed by the Crittenton Children’s Center and every year serves more than 3,000 children in parts of Kansas and Missouri.

The Head Start Trauma Smart magazine laid out some of the problems engendered by dysfunctional families and chaotic environments:

Left untreated, we now know that childhood traumatic events are strongly correlated to increased risk for alcoholism, drug abuse, depression, suicide attempts, nicotine addiction, sexually transmitted diseases, obesity, heart disease, lung disease, skeletal fractures, and liver disease.

Chronic childhood adversity can impede the brain from developing normally. Without the ability to call upon memory or sequential thought processes to cope with problems children are unable to make good decisions. This includes decisions about eating patterns.

In many cases, children will overeat for comfort, to drown out the feeling of profound unsafety. The CEO of Crittenton, Janine Hron, says:

Their emotions overwhelm them. They have difficulty sleeping, difficulty tracking in class, they act out, and then they get kicked out of school.

They also are at risk of becoming obese, a condition that introduces a whole new batch of problems into an already troubled life.

Your responses and feedback are welcome!

Source: “Is guided self-help effective in treating childhood obesity?,” UniversityofCalifornia.edu, 04/03/13
Source: “Teaching Children to Calm Themselves,” NYTimes.com, 03/19/14
Source: “Creating Trauma-Informed Head Start Communities,” SaintLukesHealthSystem.org, Summer 2013
Photo credit: Nic McPhee via Visualhunt/CC BY-SA

Eating and Other Strange Behaviors

illustration-hand-dangling-man

When Childhood Obesity News published a series of posts about Body-Focused Repetitive Behaviors (BFRBs) the first one compared compulsive repetitive behaviors like fingernail gnawing with compulsive eating. For starters, they happen under many of the same circumstances. The person is obliged to stay in one position (riding in a car, sitting in class) or has voluntarily become lodged in a sedentary pose (watching TV, reading) and engages in some kind of compulsive behavior.

There is also a shared element of intentionality. Momentarily unable to engage in a compulsive behavior, a person might look forward to being home alone, where the scab on the scalp can really be properly addressed, or the bag of cookies can be reduced to crumbs.

At other times, both compulsive eating and BFRBs are totally unconscious. Husbands drive their wives crazy with beard-stroking, and wives drive their husbands crazy with hair-twiddling. Or a person studying for an exam might realize with horror that she has unknowingly pulled out a whole patch of hair. Another student might realize with equal horror that he has consumed a party-size bag of chips.

At any rate, that post elicited a response from a reader named Josh, who wrote:

This is accurate to the letter. I stumbled upon this article a few hours after a binge-episode. What do you know — I’d been picking my head/face as I was reading, semi-consciously. I’m thinking the stress leading to the compulsive acts comes from excessive energy input/minimal output (the impulsive behaviors act as an attempt by our bodies to expend the excess energy… [T]his is why exercise has the effect of calming the impulses). The dieting, binge/restriction cycle, obesity, etc is a symptom of a disconnect from our internal hunger cues.

Dr. Pretlow replied to the comment:

Josh, I feel your pain and frustration. Fortunately, there are methods that help BRFB’s, which work equally well for compulsive overeating. You are correct that, like BRFB’s, compulsive eating involves the expenditure of nervous energy, but also accomplishes displacement/distraction from the stress. Internal hunger cues are completely overridden by the urgent need to cope with the stress. Squeezing your hands together and taking a deep breath, holding it for a sec, and letting it out helps to expend the nervous energy. Letting the urge to binge come over you like a wave, but relaxing, “surfing” the urge, not acting on it, and distracting yourself can help avoid bingeing. Writing down your stresses and a plan to deal with each stress also helps. Plus, stay out of the kitchen, call a friend, or go dance it off.

There are also shared characteristics between BFRBs and another alphabetical problem, OCD (Obsessive-Compulsive Disorder), in which things must be done only one way, at the risk of violating some universal law. A person might feel that it is a rule to eat cookies only in a certain mathematical progression. You can eat three, but if you mess up and eat four, then you have to go to the next multiple of three, and eat six. Or, a person might hold a belief that the whole package of cookies has to be finished at one sitting, because to do otherwise would open the door to existential chaos.

Since there is no possibility of doing deep psychoanalysis on every person with a problem, therapeutic modalities are needed that can override a certain amount of mental/emotional disturbance, and work effectively for people with a wide range of underlying dysfunctions.

Your responses and feedback are welcome!

Photo credit: Internet Archive Book Images via Visualhunt/No known copyright restrictions

Pet Obesity and a Certain Amount of Weirdness

dachshund-getting-a-treat

When humans raise children a lot of factors enter the equation. Raising a pet is kind of a stripped-down version of child-rearing, with fewer complications, and more potential for the parent to control the situation. This may be why irregularities and aberrations are more obvious in pet-parents. When a human lives alone in an apartment with an obese dog that never goes out, it is obvious where the responsibility lies.

When Vincent’s human died, the 8-year-old dachshund was turned over to K-9 Angels Rescue in Houston, Texas. Little seems to be known about the former pet owner, but since Vincent also has serious periodontal disease it was probably someone disabled and/or impoverished, without the means to provide either exercise or medical care for the companion animal.

Veterinarian Sharon Anderson told the press about Vincent:

At his original BMI, he was at a severe risk for arthritis, diabetes, reduced mobility, increased physical injury that can lead to paralysis of the hind legs, cancer, respiratory disease, kidney disease, pancreatic and shortened life expectancy.

The picture here on our page is not Vincent, but the celebrity dachshund can be seen at SeattlePI.com. In their photo, poor Vincent is lying on his side, his body grotesquely swollen into a rectangular shape, with fat trying to burst through the straining skin. He had a BMI of 62.7 and weighed 36 (or 38 or 40, depending on the source) pounds. Any of those original numbers would be more than twice his ideal weight, calculated at 16.89 pounds.

With the help of the vet and the foster mom who later adopted him Vincent made a full recovery. The point here is that pets can become morbidly obese, and they can also recover if given the opportunity for a new lease on life.

Into the dark

Co-dependency takes many forms. It can manifest as an inability to say no, through fear of the loss of affection. We mentioned a pet-owner who found entertainment in overfeeding a dog because of the amusing way its eyes popped out in anticipation of a treat.

A human like this might also be obese, and enjoy bringing the pet into the obesity club just for the camaraderie. Or it could be the opposite. A human who absolutely must stay slim (a TV newsreader for instance) might keep a pet as an eating surrogate, fondly indulged with treats.

Dr. Pretlow says:

I believe that parental co-dependence is likely an important factor in childhood obesity development and thus prevention and treatment.

The same holds for pets, as Dr. Pretlow and Dr. Ronald J. Corbee suggest in their British Journal of Nutrition article, “Similarities between obesity in pets and children: the addiction model.” In its most extreme form, co-dependency is like emotional vampirism, with one partner being nourished by the life essence of the other.

In the weird psychological kink “Munchausen by proxy” (or MBP), the parent causes illness in the child or pet in order to reap attention, gratitude, admiration, the self-aggrandizement of being perceived as a devoted caregiver, and the thrill of feeling like a professional colleague when working with medical personnel. The afflicted human needs so desperately to be needed that causing disease in an alleged loved one seems like a viable choice.

Myrna Milani wrote for The Canadian Veterinary Journal:

In human medicine, MBP is classified as a form of abuse and diagnosed in 2 ways: by hospitalizing the child and using hidden cameras to observe parental interaction, or observing the recovery of the child when taken away from the parent. However, little is know about the psychodynamics of the condition, because those affected often vehemently deny any accusation, even when presented with proof. Additionally, most also resist or refuse any therapy.

The literature includes many similar observations, so pet-parents are definitely not immune to this strange disorder.

Your responses and feedback are welcome!

Source: “Houston dachshund known as fat Vincent is now ‘skinny Vinnie’ after dramatic weight loss,” SeattlePI.com, 04/09/16
Source: “Problematic client-animal relationships: Munchausen by proxy,” NIH.gov, December 2006
Photo credit: Howard O. Young via Visualhunt/CC BY

Kids, Pets, and Withdrawal

fat-orange-cat

It is still National Pet Obesity Awareness Month, and we have been talking about what happens when a pet-parent institutes a program designed to halt the companion animal’s addiction to overeating. All the details are present in “Similarities between obesity in pets and children: the addiction model,” co-authored by Dr. Robert A. Pretlow and Dr. Ronald J. Corbee, and published in the British Journal of Nutrition. We will mention a few more highlights here.

First, the pet-parent (or child-parent) helps pet or child at risk for obesity to identify and eliminate any foods that particularly act as addictors for them. Then, between-meal snacks are removed from the repertoire. Although resistance may pop up at any time, it is most likely to become serious at the next stage, the gradual reduction of mealtime portions. We mentioned that both children and pets may protest by withholding affection or chewing up unauthorized objects (dog), leaving an unpleasant souvenir in an unexpected place (cat) or throwing tantrums (small child.)

Anyone who has seen a documentary about an extremely obese person who can no longer walk, must have wondered, “Why doesn’t the caregiver simply stop bringing in huge amounts of the wrong kinds of food?” The reason is emotional blackmail. A caregiver who has few other human connections and very little outside life can’t afford the emotional distress of incurring the anger or emotional coldness of the obese person. This is an extreme version of the minor-league aggravation caused by a pet or small child that doesn’t get its way.

What else do they do?

Of course, to a parent in the midst of that kind of chaos it doesn’t seem so minor. An already-harried parent whose child knows for a certainty that there are treats in the kitchen is likely to give in, because to pack the child in a crate and mail it to another state would be illegal. This is why parental education is so essential, and why programs meant to curb child obesity depend on the entire family’s participation.

Pestering, of course, is an art form also practiced by pets. The ideal for a cat is to get it down to three distinct meals per day, with no extra treats, and no food left in the bowl for casual grazing. The felines are not known for their compliant ways, and a cat who objects to a new regime is likely to wake its pet-parent in the middle of the night. A more well-adjusted cat might chill out most of the time, but get all hyper and demanding the moment the human steps into the kitchen.

Entering the kitchen is known as a trigger, and vigilant trigger avoidance might be necessary. It might help to keep pet food sealed up tightly, so the animal is not tormented by the constant scent of food.

A dog or a small child can be distracted by play, or going for a walk, but the circumstances aren’t always right for those solutions. One way or another, everybody would be well-advised to learn some new coping skills. Dr. Pretlow and Corbee mention another potential roadblock:

An additional problem in pet obesity lies in multiperson households. As pets cannot speak, they will constantly take treats from every person in the household. As all caregivers like to give food and treats to their pets, the behavioral addiction methods should be used by all caregivers.

With kids or pets, if more than one grownup is involved in the de-addiction effort, they need to be “on the same page” and present a united front. If the parents disagree, and compete against each other for favor, it’s a recipe for disaster. And then grandparents weigh in, with absolutely no intention of being told what they can feed their grandkids, and issues of cultural preservation might even be raised. The message to pet-parents is, you probably have it easier in many ways — so appreciate that advantage, and help your pet get down to a healthy weight.

Your responses and feedback are welcome!

Source: “Similarities between obesity in pets and children: the addiction model,” Cambridge.org, 06/17/16
Photo credit: Les Chatfield via Visualhunt/CC BY

More About How to Help Kids and Pets

big-cat-sleeping

When babies and pets are allowed to develop an expectation that every bite of every food will always be delicious within certain narrow parameters (i.e., sugary, for babies), they start off on the wrong foot. Unfortunately, parents often don’t realize that the liquid nutritional supplements they are guilt-tripped into buying are just a sludge of sugar and fat. (See Dr. Pretlow’s “Food Supplements and Childhood Obesity“).

An overwhelmingly sweet diet can really throw the human palate out of whack. A child who has never experienced anything except sweetness-enhanced food will have difficulty adjusting to things like vegetables. Good fresh broccoli tastes like good fresh broccoli, but it doesn’t taste like a hot-fudge sundae.

In the fabled 60s, some people found that psychedelic drugs allowed them to appreciate the flavors of raw, whole foods for the first time. Little babies are like that. They deserve a chance to find out what unsweetened food tastes like. Thousands of generations of humans have survived sugarless childhoods.

So have thousands of generations of animals, before humans got involved. Cats are unimpressed by sugar because they can’t taste it. Dogs like sweetness, but shouldn’t have it. There is absolutely no reason for sugar to be in dog food, yet it is there. Pet-parents, read the ingredient list carefully! Dogs are said to like onion and garlic, which is surprising but beneficial. An adult dog, by the way, only needs one meal per day.

In the mind

We have been talking about the unhealthy and very unhelpful co-dependency that can afflict pet-parents, preventing a good resolution of the overeating addiction. An example comes from a dog-lovers’ forum:

Just seeing his eyes light up when I present him with a raw chicken part is absolutely precious, lol! When he goes to take it his eyes totally bug out and he looks like a psycho dog! BTW, this is one of my favorite pictures… I’m torturing him with the “Leave it” command while I take pictures, lol! The “cake” is actually turkey meatloaf with peanut butter “frosting.” I just love the way dogs look right before they get food…

Those remarks are borderline pervy, and it would not be surprising if the pet-parent who wrote them is morbidly obese. On general principle, check out this introduction to the subject of pet obesity.

Then, let us resume yesterday’s discussion about what happens when a pet-parent or child-parent initiates a program designed to reverse the addiction to problem eating.

Dr. Pretlow’s studies of the W8Loss2Go smartphone app have shown that the first two stages, where the subject leaves behind specific problem foods and quits snacking, are relatively smooth. The next step is to cut down mealtime servings, and then, the psychological environment might change.

This quotation is from the article that Dr. Pretlow co-authored with Dr. Ronald J. Corbee:

Withdrawal from excessive food amounts at meals was associated with significant withdrawal symptoms including nagging urges, agitation and even anger. Hence, in pets, withdrawal from excessive amounts at meals may prove more difficult than withdrawal/abstinence from specific treats.

Both kids and pets do things that a grownup needs to be ready for. Withholding affection is a classic ploy — giving the parent the cold shoulder. Anger is very hard to deal with, especially with kids, because so many other issues intrude. Pets find their ways of exacting revenge. To meet these behaviors, it’s a good idea to prepare by studying up beforehand.

Your responses and feedback are welcome!

Source: “Similarities between obesity in pets and children: the addiction model,” Cambridge.org, 06/17/16
Photo credit: Martin Cathrae via Visualhunt/CC BY-SA

How to Help Kids and Pets

overweight-dog

A while back, we described the first two steps of W8Loss2Go as it pertains to both children and pets. We are still in Pet Obesity Awareness Month, so more discussion follows. The program begins with identifying the specific problem food or foods, and withdrawing from them one by one. Then, between-meal eating is eliminated. Ideally, the intake is now down to just regular meals composed of healthful, non-problem foods.

Next, the portion sizes of the regular meals are gradually decreased. A scale is very useful here because as a tangible, legitimate scientific instrument, it reminds the responsible parent that this whole enterprise is valid and beneficial. For the pet-parent or child-parent, the scale performs a wholesome psychological function. With a pre-made plan of how much will be doled out, and when, emotional factors have less opportunity to get in the way.

Moving on

The plan is described in a British Journal of Nutrition article written by Dr. Robert A. Pretlow (to whose work Childhood Obesity News is devoted) and Dr. Ronald J. Corbee, Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University. In “Similarities between obesity in pets and children: the addiction model,” they mention that, in theory anyway, the access that pets have to food is more controllable than the access afforded to children, especially when those kids are old enough to go outside on their own. Relative to dealing with teenagers, it would seem that controlling the availability of unsuitable food to very young children should be easy.

But in real life the co-dependence of the child-parent or pet-parent is an issue. Because of the tangled psychology, adults are capable of rationalizing their actions in a hundred ways. In a grownup’s mind, there may be a perfectly good reason to fill the baby’s bottle with soda pop or give a bowl of ice cream to a dog that can hardly lift its own weight from the floor. The authors suggest that in addition to decreasing the portion sizes at meals, the parent might de-pleasurize foods whenever possible.

If foods are not as tasty, children and pets tend to eat less. For example, in children, if there is a particular problem with mashed potatoes, which typically are made with butter, cream and seasoning, they can be prepared as boiled potatoes with just seasoning. Increasing the fiber content and decreasing the fat content of pet food are ways to reduce energy consumption.

Dr. Pretlow and Corbee also warn that this part of the plan might not go over well:

Pets and children may be annoyed by this de-pleasurising and initially refuse the less tasty foods. Perseverance by the pet–parent and child–parent is key, if this theory holds true for pet eating behaviors.

A very old proverb says, “Begin as you wish to continue,” and obesity prevention is an area of life where the saying is elevated to the status of a commandment. Numerous studies have shown that the earlier obesity sets in, the harder it is to reverse. Babies and pets really shouldn’t be allowed to develop an expectation that everything they every put in their mouths will be hyperpalatable.

Your responses and feedback are welcome!

Source: “Similarities between obesity in pets and children: the addiction model,” Cambridge.org, 06/17/16
Photo credit: Lisa Cyr via Visualhunt/CC BY

The United Kingdom’s Ongoing Obesity Struggle

rows-of-lollipops

Following along with the recent history of obesity suppression efforts in the United Kingdom, last fall activist chef Jamie Oliver sponsored a petition meant to convince the government to tax sugar-sweetened beverages (SSBs). He pointed out that such a tax could bring in £1 billion per year, which, if used properly, could make a slight dent in the nation’s annual £9 billion expenditure on treating people with diabetes.

Though Oliver’s petition gathered more than 140,000 signatures, it failed to sway the government, which didn’t act. Foodingredientsfirst.com wrote that many Brits were dismayed by the failure of similar tax measures in other countries.

Sirpa Sarlio-Lähteenkorva, of Finland’s Ministry of Social Affairs and Health, wrote in the British Medical Journal:

When some foods become more expensive consumers tend to look for cheaper substitutes. These cross elastics of demand need to be considered carefully when planning food taxes. It has been suggested that to influence consumption the price increase has to be at least 20%…

The potential for improved health is greatest when combined with incentives for choosing healthier foods.

One incentive for making more healthful choices is to not have junk food shoved into one’s line of vision all day long. The retail chain Morrisons announced that it would change the environment of its checkout lines to only hold fruit and nut snacks rather than candy. Readers will recall that Morrisons has already been doing this for one-fifth of its checkout lines, and, apparently, harassed parents let their appreciation be known.

Their move to junk-free checkouts was scheduled to be completed by February of 2016. However, as of March, the British press was still referring to “a pledge from Morrisons.”

In October of last year, Public Health England (an operationally autonomous executive agency of the Department of Health) issued a 48-page report titled “Sugar Reduction — The Evidence for Action.” It covers the Scientific Advisory Committee on Nutrition’s (SACN) “Carbohydrates and Health” report, the potential cost savings that the government’s health budget would experience if SACN’s recommendations were followed, and programs called Change4Life, 5 A Day, and Eatwell.

Also in October, health secretary Jeremy Hunt was criticized for refusing to disclose the results of a scientific review of the sugar tax issue. Hunt said the report would be published later in the year, but segments of the public resented the fact that he had already been dragging his feet since previous July.

Meanwhile, the National Health Service maintained that SSBs and junk food kill 53,000 of the Queen’s subjects each year and cost the equivalent of nearly $8 billion. The British Medical Association was still holding onto the demand for a 20% tax on fizzy drinks, and the Coca-Cola Company was discovered to be funding quite a lot of supposedly neutral scientific research.

Your responses and feedback are welcome!

Source: “British Government Rules Out Tax on Sugary Drinks, Despite 100,000-Strong Petition,” FoodIngredientsFirst.com, 09/23/15
Source: “UK: It’s time for govt to wake up to ‘obesity time bomb’, expert warns,” FreshFruitPortal.com, 09/29/15
Source: “Sugar Reduction — The Evidence for Action,” gov.uk, October 2015
Source: “Too Sweet to Handle: UK Health Minister Sugarcoating UK Obesity Crisis,” SputnikNews.com, 10/12/15
Photo credit: Ruth Hartnup via Visualhunt/CC BY

Childhood Obesity News | OVERWEIGHT: What Kids Say | Dr. Robert A. Pretlow
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