Passive Enabling and Child Obesity

2007-04-28

In the previous post, Childhood Obesity News considered the difference between active and passive enabling. During Childhood Obesity Awareness Month, it becomes clear that for a parent to be unaware is a kind of passive enabling. The goal is to bring public consciousness to the point where it is simply impossible for parents to remain oblivious to the reality of their own situation and their children’s.

One very large problem is that overweight and obesity have pretty much become the “new normal.” Perception is always influenced by the environment. When parents see their kids among classmates and friends of the same age, a lot of extra pounds become invisible because, next to a child who is 100 pounds overweight, a child who is a mere 25 pounds overweight doesn’t look so bad.

Looking into the matter

Studies of parental awareness have been done before, as Karen Kaplan explains, with mixed results. (Some parents have resisted warnings that their children are overweight because they believe the standard should not be the same across races and ethnic groups.) Researchers from three universities teamed up to look back at the CDC’s National Health and Nutrition Examination Survey. They wanted to see if parents have always been so blind to their children’s obesity.

They compared the records of two different batches of kids — some tracked from 1988 to 1994, and a comparable group tracked from 2005 to 2010. All these kids had participated in studies where their parents (usually the mothers) were asked to assess the child’s weight as “too high, too low or just about right.” All the numbers are in Kaplan’s article, and here is the gist:

A new study in the journal Pediatrics finds that American parents are significantly less likely to make an accurate assessment of their children’s weight compared with parents from an earlier generation. If moms and dads don’t see the problem, they aren’t likely to be part of the solution, the researchers say.

Here is pediatric dietitian Melanie R. Silverman on the problem of post-soccer practice snacks:

To have cupcakes, candy, brownies, chips and sugary drinks brought by parents and handed weekly to our kids on the soccer fields after their games sends the wrong nutritional message…. [W]eek after week, parents complain to me from all over the country about the types of soccer snacks served in their towns. They are outraged and fed up. And they should be.

Especially disturbing are the times when athletic practice runs from, say, 11 a.m. until noon. Nobody should be having any post-practice snacks at lunchtime, or any drinks except water. Remember the old saying, “Hunger is the best sauce.” A child who has just worked up an appetite through athletic practice is a child in a position to appreciate a heaping plateful of steamed veggies or a nice salad. This might even be the opportunity to introduce some new, untried food. How sad to have it thwarted by the child being full from ingesting two doughnuts and a bottle of soda.

When parents allow a situation like this to persist, it is a kind of passive enabling that doesn’t have to continue.

Your responses and feedback are welcome!

Source: “New culprit in childhood obesity,” examiner-enterprise.com, 08/27/14
Source: “Soccer Snack Insanity,” HuffingtonPost.com, 11/06/2013
Image by Warren Long

9 Ways to Avoid Enabling

charity jumble sale

We are almost to the end of Childhood Obesity Awareness Month, but don’t be fooled — we need to keep that awareness level high during the other 11 months, too.

A parent might think, “What’s the beef? I never tied my kid down, stuck a funnel in his mouth, and poured in milkshakes fortified with extra calories.” And indeed, most parents never have performed such an unthinkable violation. But like aggression, enabling comes in more than one format. There’s active enabling and there’s passive enabling, or what in theology would be called sins of commission versus sins of omission.

The main thing to know about enabling is, we want to avoid it in any guise. Here, two previous posts describing “Parents as Enablers and Saboteurs” are distilled into simple “dont’s.”

● Don’t use food as a bribe to elicit good behavior.
● Don’t use food as a reward for good behavior.
● Don’t use food to win more love than the other parent gets.
● Don’t bring home junk food if your child has specifically asked you not to.
● Don’t overreact to a notification that your child is overweight.
● Don’t serve processed meals from packages.

● Don’t dismiss the idea of cooking from scratch.
● Don’t ignore a notification that your child is overweight.
● Don’t deny your own issues or addictions.

Those last three are separated because they are examples of passive enabling. About the cooking — a grownup who serves processed, packaged, and pseudo foods is actively promoting obesity, but a certain amount of passive enabling is going on at the same time. When a parent abdicates responsibility for a truly vibrant diet, overweight and obesity are passively enabled.

Just because life is already too busy with pressing demands, that doesn’t mean a parent can blow off the idea of ever learning to cook healthful meals with fresh ingredients, fewer calories, and zero harmful additives. Could it be a family project, to plan the perfect healthful Sunday brunch and shop for the ingredients? And then to go ahead and make that meal from scratch? It wouldn’t hurt to try something different, once.

As we know, Dr. Pretlow is working on the W8Loss2Go smartphone application. At one point he observed:

When I talked with the parents of the kids in our current app study, they readily acknowledged that parents enable this problem in their kids. One mother said her 10-year-old, who’s in our study, became panicky at a recent church festival because of all the food available. ‘How can I keep from eating this?’ he agonized to his mom.

What could that mother have done differently? Depending on various other factors intrinsic to family situation and environment, one course might be to avoid the church festival altogether and choose a different activity. Or, an energetic parent might join the event-planning committee and actively campaign to convert the food offerings to more healthful alternatives.

A slightly more ambitious parent might decide to make a mother/child project out of creating a festival booth to feature delicious low-calorie snacks, and give away the recipes for other families to try. A truly audacious parent might propose the radical idea of restructuring the whole event so as not to include food at all.

Solutions call for originality, “outside the box” thinking, and a willingness to abandon old habits and start new ones.

Your responses and feedback are welcome!

Image by badgreeb fattkatt

How to Observe Childhood Obesity Awareness Month

i got dizzy

Much of our current understanding of the childhood obesity crisis comes from highly respected institutions. To pick a random example, after research was done at Harvard Medical School and the Harvard School of Public Health, the authors made suggestions about what two different groups should do.

They would like to see a collaboration between the Food and Drug Administration, the Federal Trade Commission, and Congress, with the objective of regulating all marketing that is directed toward children. Another goal would be to repurpose the Farm Bill to subsidize fruits and vegetables. Also, primary-care physicians are encouraged to face reality — childhood obesity is “one of the most prevalent chronic diseases.” The Harvard researchers would like to see more cooperation between their fellow scientists and the medical profession, the advocates of public health, experts from the area of business and law, and of course parents.

Room to move

Joanna Rothkopf of Salon reported on a recommendation that in most places would take a lot of community support to implement: increased availability of public lands for people to actually use for activities like hiking and trail biking. Researchers from the state universities of both Missouri and Minnesota looked at some Minnesota towns. Rothkopf says:

The study found that counties with more trails and forests had higher levels of youth activity and lower youth obesity than counties with fewer opportunities for outdoor recreation.

The trouble is, in urban areas, trails, parks, and playgrounds seem to have become increasingly likely to harbor crime rather than healthy exercise. Parents can contribute greatly to the community and help reduce childhood obesity by advocating and supporting safe, accessible recreational space in all neighborhoods.

The great outdoors

For Outside Online, Katie Arnold reported on the message of Peter Gray, PhD. In the American Journal of Play, he summarized what is to be learned from two University of Michigan studies about children’s play. Gray conveyed the news that between 1981 and 1997 children’s total play time diminished by 25% and outdoor playtime was cut in half. Guess how much time per day the average contemporary child spends “goofing off outdoors” — between 4 and 7 minutes.

Sure, kids have school sports — the ones who can afford the uniforms, equipment, and other expenses. But one of the reliable sources of exercise enjoyed by previous generations — walking to and from school — has almost become extinct.

In his research, Gray posits that children who don’t play are more likely to suffer from anxiety and depression; childhood obesity and diagnoses of attention-deficit disorders are on the rise. Play teaches children how to work together and mature into more socially well-adjusted adults; it has also been proven to build better brain function and improves academic performance.

Dr. Stuart Brown, a psychiatrist and clinical researcher who founded the National Institute for Play, calls play “a fundamental survival aspect of all social animals.” Through his research of homicidal males in the 1960s, he found that a lack of “normal give-and-take play behaviors” may even be an indicator for mass violence.

Arnold urges parents to put their kids outside more, and even offers helpful instructions for the forgotten art of communicating with other parents about visits and guidelines for safety.

So if parents wonder how to commemorate Childhood Obesity Awareness Month, here is a clue. Work toward the establishment and maintenance of useful, safe play areas in your neighborhood, and encourage not only your own children but others to get out there and run around.

Your responses and feedback are welcome!

Source: “Kids are what they eat,” Harvard.edu, 09/26/12
Source: “How the built environment is contributing to childhood obesity,” Salon.com, 09/11/14
Source: “America Needs a Playtime Intervention,” OutsideOnline.com, 08/27/14
Image by guilherme jofili

Globesity — Norway and the Netherlands

Taking the World by Storm

In the Netherlands, only 4% of the children are overweight, according to NBC News. Apparently the source is the Institute for Health Metrics and Evaluation, although a visit to their data visualization page seems to indicate that the percentage is 17.2. This particular microcosm illustrates the problems inherent in keeping current with, and conglomerating, obesity statistics.

To be relevant, numbers need to match in the ways they were collected and the populations they were collected from. Different countries have different ways of gathering statistics, and vastly different resources with which to do it. The attitudes of various governments toward statistics-gathering range from meticulous to lackadaisical, and their reporting requirements — and penalties for missing the mark — reflect this.

If one place defines “children” as aged 2-16 and another place defines them as aged 5-18, how can the collected numbers be compared in any meaningful way? To grasp the worldwide picture is very difficult, and experts must depend on approximations in reporting, because precision is not obtainable.

A new study

In the Netherlands, the National Institute for Public Health and the Environment collaborated with the World Health Organization to assess how community-based initiatives (CBIs) to reduce childhood obesity are working out. The study looked at measures begun in the years 2005-2011. The areas of inquiry were the CBIs’ general characteristics, applied strategies, and reported effects.

The researchers sorted through a lot of available data sets to select the ones that matched their study’s criteria. The 71 selected included projects originating in 15 different countries. Almost all of them “implemented both environmental and individual strategies.” About half were public-private partnerships, and more than half carried out activities in multiple locations, or throughout a neighborhood.

The initiatives varied in nature — heavy on the professional training and offering many programs for parents, with plenty of attention to making changes in the social and physical environments. Much interesting information can be gleaned from this report, whose conclusions are:

Despite diversity of included CBIs, common characteristics were the application of integrated actions at a local level, aimed at changing the environment and the children’s behavior directly. Evidence supporting effectiveness on weight indicators is available, although the design and conduct of most of these studies were suboptimal (i.e. no control group, a small sample size, not random).

From the Norwegian Institute of Public Health, the good news is that between 2008 and 2012, Norwegian third-graders did not get any bigger on the average. The Institute’s Child Growth Study also identified some factors affecting child obesity, including the educational level of the child’s mother, whether the parents are married, and whether the family lives in a rural or urban environment. As might be expected, children with undereducated mothers and divorced parents do not fare as well.

Perhaps surprisingly, because of the stereotypical picture of hard-working country kids, the rural Norwegian children experience more overweight and obesity than city kids. But unlike their counterparts in other countries, the majority of Norwegian children get back and forth to school either on foot or via bicycle. Also unlike their counterparts in other countries, Norwegian officials are very concerned about social justice and fairness. The Child Growth Study’s project manager, Ragnhild Hovengen, is quoted as saying:

Health clinics and school health services have a unique opportunity to identify children and families at risk of developing obesity and other health problems and they must be encouraged to introduce preventive activities among children and young people in their municipalities…. There is a danger that trends in overweight and obesity in some groups will help to maintain and increase social inequalities in the years to come.

Your responses and feedback are welcome!

Source: “The Whole World is Getting Fatter, New Survey Finds,” NBCNews.com, 05/27/14
Source: “Overview of 71 European community-based initiatives,” MyJournals.org, 07/28/14
Source: “Childhood obesity unevenly distributed in Norway,” HealthCanal.com, 08/20/14
Image by JD Hancock

Globesity in Some English-Speaking Countries

cool globe chicago recyclable waste

Last time, Childhood Obesity News looked at developments in the United Kingdom, and today we take a peek at what has been going on with one of England’s neighbors and two of its former colonies.

In Ireland, there are 300-pound teenagers and growing concern. The country has a hospital-based service, W82GO, for obese children up to age 16. Currently, 91 patients are on the waiting list (average wait time 20 weeks) for its healthy-lifestyle program. Fiona Dillon describes it as providing families with guidance about activities, as well as counseling in health, nutrition, and self-esteem. The staff includes a clinical psychologist, a pediatrician, a physiotherapist, a nurse, and a dietician. The director is senior physiotherapist Grace O’Malley, who is quoted as saying:

Your sleep controls your growth but also your appetite, so a lot of kids who are not sleeping will gain weight. It becomes harder to move around, and there can be breathlessness, sore joints and there is very often an embarrassment associated with moving. We have had some really good success with teens. And when we get the children younger it’s easier because they have got growth on their side.

O’Malley is not the first health professional to point out that younger is better. The earlier an intervention can happen for a child sliding into obesity, the better. Best of all, of course, is prevention, always.

The University of British Columbia issued a report that found obesity rates “at an all-time high,” with at least one quarter of all Canadian adults qualifying as obese. But the Fraser Institute, according to an uncredited Huffington Post article, disagrees. The think tank published its own report with the title, “Obesity in Canada: Overstated Problems, Misguided Policy Solutions.”

So one group is saying that Canadian obesity increased between 2003 and 2012, and another is saying it did not, and it all comes down, apparently, to how they massage the numbers. Part of the confusion comes from either reliance on, or doubt of, BMI measurements, which is a whole different and important issue. What the Fraser Institute does not seem to want is for government money to be spent on anti-obesity initiatives, which would impose costs indiscriminately on everyone of every weight class. The reporter says:

In response to the claim that obesity places additional burden on Canada’s health care system, the institute says that most costs are borne by the individual in the form of lower income, more sickness, fewer employment opportunities and possibly a shorter life span.

In the minds of many people in other countries, Australians are a hardy race of wiry, toned crocodile wrestlers. This stereotype is unfortunately not accurate. In fact, 60% of the adults are classified as overweight or obese, along with 25% of the continent’s children. One major movement is to discover what type of intervention helps families most, because there is no doubt that the entire family needs to be involved in the weight-loss efforts of any member.

Interestingly, parents with unhealthy eating habits often resort to controlling-type feeding strategies (such as pressure to eat and overt restriction) in an effort to develop healthy eating habits in their children. Such strategies appear counterproductive, as they interfere with kids’ ability to self-regulate their appetite, adversely affecting their eating habits and, in turn, their weight.

Like many of their counterparts elsewhere, Australian health-care professionals and authorities recommend family meals, home cooking, fresh produce, smaller portion sizes, and involving children in the preparation and if possible the growing of food. They urge parents to switch over to treats and rewards that are not edible, and most importantly, to substitute water for sugar-sweetened beverages.

Your responses and feedback are welcome!

Source: “Irish teens weighing 22 stone on waiting list for obesity programme,” Independent.ie, 08/21/14
Source: “Obesity Epidemic In Canada A Myth, Says Fraser Institute,” HuffingtonPost.ca, 04/29/14
Source: “Tackling childhood obesity: Part One,” ATMA.com.au, 09/02/14
Image by John LeGear

Globesity — United Kingdom

17 Sorten Fett

Yesterday, Childhood Obesity News talked about obesity around the world. Dr. Pretlow once said:

Poor lifestyle choices is commonly touted as the reason for the obesity epidemic. Yet, obesity is rapidly becoming a worldwide epidemic as countries adopt a western diet and import western products. Why is obesity spreading at an alarming rate globally? It doesn’t make sense that it is as simple as the spreading of the adoption of poor lifestyle choices.

Everywhere, the answers to those questions are being sought. In the United Kingdom, which encompasses England, Scotland, Wales, and Northern Ireland, 64% of adults are classified as overweight or obese. Three areas of north-west London have childhood obesity rates that are among the highest in England. The National Child Measurement Programme found that among 10- and 11-year-olds, 39.8% of the children were overweight or obese in Brent, and 39.4% in Westminster and Hounslow.

Why? The apparent answers are: portion sizes, deprivation, fast food, busy parents, and a sedentary lifestyle. Buyana Ailoo, leader of the Healthy Weight Team in Hounslow, remarked that parents tend not to see obesity as an urgent problem. In London, which is now home to so many immigrants, cultural expectations are different. Especially in the lower economic strata, many parents with fat babies and chubby kids feel blessed. When childhood obesity reduction is the goal, this is a difficult mindset to work around.

In Blackpool, an oceanside city in northwest England, the suppliers and vendors of school uniforms have a story to tell. (Unlike their American counterparts, many British public schools require that kids from age 4 to 16 wear uniforms.) The wholesalers and retailers have dropped the word “average” from their vocabulary.

In a country where the average grown woman takes a size 16 (about the equivalent of a U.S. size 14), one shop had to order a size 24 skirt for a girl in secondary school. The story doesn’t specify how many inches around the waist a size 24 is, or whether it is more or less than the waist size reported by another shopkeeper who supplied a skirt with a 36” waist. A third vendor reported taking an order for a blazer with a 48” chest for a secondary school student and one with a 38” chest for a younger child. Those are a lot of inches for any kid.

Dr. Arif Rajpura, director of public health in Blackpool, would like to see the government do something about fast food establishments, as well as the low price and easy availability of sugar-sweetened beverages. He is quoted:

‘Obesity is a national problem, and unless we do something here and now our future generations are going to have poor health. These issues start in childhood, and to see excess weight from reception class onwards is a worry.’

The picture on this page shows a typical full English breakfast, as served in Paddington.

Your responses and feedback are welcome!

Source: “Child obesity in north-west London among worst in England,” getwestlondon.co.uk, 12/16/13
Source: “Supersize kids sees uniform sizes expand,” BlackpoolGazette.co.uk, 09/16/14
Image by Christian Kadluba

Globesity Reigns

Atlas

Poor Atlas, that mythological figure who must carry the weight of the world on his shoulders. Since 1980, he has noticed it getting heavier. There are now four times as many overweight and obese adults as in 1980, according to the Future Diets report issues by the Overseas Development Institute.

Put another way, this means one in three people is overweight. Consequently, humans are having a lot more diabetes, strokes, and heart attacks. Most of the damage occurs in what is called the “developing world,” or what used to be called the Third World. In developing countries, 904 million people are now considered overweight or obese. In China and Mexico, obesity rates have almost doubled since the year picked for the beginning of measurement for this report.

In May, Maggie Fox for NBC News wrote about another study that used 1980 as its starting point, this one performed by the University of Washington’s Institute for Health Metrics and Evaluation. Fox says:

Perhaps most troubling, kids are heavier than ever…. The percentage of overweight or obese children and teenagers has increased by nearly 50 percent since 1980 and now more than 22 percent of girls and nearly 24 percent of boys in developed countries are overweight or obese.

And according to this survey, nearly one-third of the world’s population (around 2.1 billion people) is overweight or obese. Not a single country among the 188 surveyed has succeeded in lowering its obesity rate since 1980. Among them, the United States is most extreme. In 12 of our states, the adult obesity rate is over 30%. We have 5% of the earth’s population and 13% of its obese inhabitants. Fox writes:

The U.S. has 78 million obese adults, the highest number of any country in the world, even China, with four times the population. Nearly three-quarters of American men and more than 60 percent of women are obese or overweight, it finds. And nearly 30 percent of U.S. children and teens are either obese or overweight, up from 19 percent in 1980.

The Institute’s director, Dr. Christopher Murray, told the reporter that as incomes continue to rise in formerly poor countries, obesity rates will continue to rise too. In other countries, as in the U.S., obesity causes or exacerbates a number of medical problems and leads to massive suffering, incredible expense, and preventable early death. It has been suggested that obesity accounts for pretty darn close to 20% of deaths in the U.S.

“Rapport” is a French word that means something like “We’re on the same page with this,” whether in intellectual understanding, emotional resonance, or both. UN literature says:

A Special Rapporteur is an independent expert appointed by the Human Rights Council to examine and report back on a country situation or a specific human rights theme. This position is honorary and the expert is not United Nations staff nor paid for his/her work.

When visiting a country, the Special Rapporteur interacts with governmental and nongovernmental bodies, expecting free access to the relevant facts. The “Special Rapporteur on the right to food” is Dr. Olivier De Schutter, who gave a speech at the annual summit meeting of the World Health Organization earlier this year.

He told the assemblage that in the 10 years since WHO began its Global Strategy on Diet, Physical Activity and Health, governments have focused on increasing food availability but have not carefully considered the quality of the available calories, the price, or the marketing methods behind this availability. In his opinion, the junk food problem is not taken as seriously as it needs to be, and the most quotable portion of his address deemed unhealthy diets a bigger threat to global health than tobacco use. Charlotte Alter wrote:

The Special Rapporteur has previously agitated for greater governmental action on junk foods, including taxing unhealthy products, regulating fats and sugars, cracking down on advertising for junk food, and rethinking agricultural subsidies that make unhealthy food cheaper.

Your responses and feedback are welcome!

Source: “Obesity quadruples to nearly a billion in developing world,” gulf-daily-news.com, 01/04/14
Source: “The Whole World is Getting Fatter, New Survey Finds,” NBCNews.com, 05/27/14
Source: “Factsheet 27,” ohchr.org, April 2001
Source: “Obesity a bigger global threat than tobacco: UN,” Time.com, 05/19/14
Image by Contando Estrelas

Childhood Obesity and Economic Disparity

McDonalds Map

A report published in Proceedings of the National Academy of Sciences gave the disturbing news that obesity rates continue to link up with income inequality. A Harvard research team found that obesity is decreasing in teenagers from well-educated (and consequently better-employed) families, while it increases among the economically disadvantaged. When the numbers in some subgroups go up while others go down, the overall statistical picture can look like a plateau.

Such misapprehensions can inspire misleading media headlines and a false sense of victory. Journalist Lauren F. Friedman explains the mystery that is involved in trying to figure out why obesity rates are different. The kids whose parents only had a high-school education — in other words the poorer kids, who were getting fat — actually consumed fewer calories than the progeny of college-educated parents, who by any logical calculation, should be getting fatter. And get this. Friedman says, “But both groups were eating fewer calories per day in 2009-2010 than they were twenty years earlier.”

It doesn’t seem to make sense, and this is one of many reasons why more research is needed. It may be that exercise is the deciding factor. Rich kids get pretty much the same amount of exercise as in past years, but poor kids are getting less exercise than they used to.

Theories have been put forth. It costs money to participate in school sports, so maybe lower-income kids are missing out on exercise opportunities for that reason. Schools in poor neighborhoods might not even have sports programs because of budget cuts. Inner-city playgrounds and parks where kids used to go for exercise may be unsafe these days.

Friedman quotes study author Kaisa Snellman on the danger of making unwarranted statistical inferences: “There’s a danger in aggregating trends in groups that are so different. The picture becomes very murky.”

For a Think Progress piece about the same research, Sy Mukherjee looked up a separate and previous study carried out at the University of Georgia in 2013, which might explain the higher obesity rates among teenagers from financially burdened families. He writes:

Lead study author Gene Brody found that poor young teenagers who do well in school, are in good mental health, and are socially well-adjusted actually end up with an excess of stress hormones because of the strains of overcoming economic adversity. Consequently, these teenagers are more susceptible to obesity, hypertension, stroke, and cardiovascular diseases from a younger age.

What a terrible paradox, that the kids best equipped and motivated for success are setting themselves up for ravaging medical conditions, just by being so responsible and hard-working. Mukherjee also mentions that this is a worldwide trend among nations, as well as people. In affluent countries, obesity rates may fall. But at the same time, there is more obesity than ever in “developing” countries.

Your responses and feedback are welcome!

Source: “America’s Obesity Crisis Is Ending — As Long As You’re Not Poor,” BusinessInsider.com, 01/15/14
Source: “Obesity Rates Falling Among Affluent/Well-Educated But Rising Among The Poor,” ThinkProgress.org, 01/14/14
Image by Maps that will blow your mind

Childhood Obesity Awareness Should Focus on Prevention

October 4 work day

One year ago, during Childhood Obesity Awareness Month, the most recent Childhood Obesity Prevention Summit was attended by nearly 300 state and local policy makers, and even some representatives of federal agencies. Other advocates of childhood obesity prevention included members of community organizations, as well as academics and professionals. The public relations material described the summit agenda:

Workshops addressed, among other topics, food marketing to children, food access in underserved communities, community development and design strategies, school-based policies and socioeconomic disparities in policy implementation.

While visiting Baltimore, summit attendees were invited to visit Druid Hill Park, known for its hiking and bicycling facilities. They could also tour the Paul Laurence Dunbar High School for Health Professions. Another site of interest was the Great Kids Farm, a project of the city’s public schools. Activities there are very similar to what goes on in other schools fortunate enough to be involved in garden-based learning.

In that same month, Zoe Mintz wrote for International Business Times about a newly identified class of risk. This condition has been defined as severe obesity, and 5% of American children are said to exist within it. But what does it mean exactly?

In children over the age of 2, severe obesity is defined by a body mass index (BMI) that’s at least 20 percent higher than the 95th percentile for their gender and age, or a BMI score of 35 or higher.

These children are looking at a future that includes one or more of the following: “Type 2 diabetes, high blood pressure, high cholesterol, liver disease, sleep apnea, musculoskeletal problems and early signs of clogged arteries.” What is worse, the treatment options are few. Modalities that are effective among other obese populations don’t seem to work for severe obesity, which is characterized as “an extremely difficult disease to treat.” Mintz includes an interesting quotation from Dr. Valentin Fuster of New York’s Mount Sinai Medical Center:

Somehow you think you’ve got it, but they come back…. This is why it’s so important to know the reasons for why you’re obese.

As for the reasons, followers of Childhood Obesity News have heard this before: Many people are obese because they are addicted to high-calorie, low-nutrition, chemical-laden concoctions that are shameful imitations of food. Yes, even people who know better! The world is full of intelligent adults, some with multiple academic degrees, whose bones are asked to support far too many pounds.

These are adults with life experience, credentials, disposable income, the ability to travel, and many other advantages. If they can’t figure out how to shed their addiction, what chance does a little kid have? Especially the ones who arrive in the “severely obese” category before any responsible adult thinks to pay attention. Since severe obesity is so intractable once it sets in, prevention is clearly of paramount importance.

Your responses and feedback are welcome!

Source: “2013 Childhood Obesity Prevention Summit,” LeadershipForHealthyCommunities.org, undated
Source: “5 Percent Of US Children Are ‘Severely Obese,’ New Risk Category Rising Among Youth,” ibtimes.com, 09/10/13
Image by Friends of West Baltimore Squares

Parents, Activism, and Community

Brentwood School Board Candidate Forum

The “Let’s Move” campaign is said to aim for a return to the normal childhood obesity rate of 5 percent, as defined by how it was in the late 1970s. In a general sense, efforts to turn back the clock inevitably fail. More specifically, the phraseology suggests that the goal is just to get things back to “as bad as they were before,” and that is not a particularly inspiring motive.

For parents who are inspired to move forward, the best advice is to start at home and make the place where your kids live the most stress-free and temptation-free food environment, and set an irreproachable example of clean living. Also, there are ways to be effective in the larger community. During Childhood Obesity Awareness Month, what do parents need to know about activism?

Know how to know

Before the average person invests time or money in a project, there had better be some indication that the effort and risk will bear fruit. How do we know if a program can help our kids, or anybody’s kids? How do we decide which kinds of community intervention to support? A good place to start might be Evaluating Obesity Prevention Efforts from the Institute of Medicine of the National Academies. The 462-page manual is subtitled “A Plan for Measuring Progress.”

We need access to the data, and a context or framework in which to weigh it. Help can be found in a chapter titled “Improving the Usefulness of Obesity Evaluation Information to Potential Users.” The report includes information on how to discern whether any given activity actually promotes health equity, and on “Community Obesity Assessment and Surveillance,” which sounds rather ominous.

Much of our current understanding of the childhood obesity crisis comes from highly respected institutions. To pick a random example, publicity about research done at Harvard Medical School and the Harvard School of Public Health said this:

There’s no question that junk food, most of it highly processed, and sugar-sweetened beverages are major contributors to the obesity epidemic…. There’s no lack of convincing research … demonstrating the solid relationship between such fare and a greater risk of obesity…. One key factor in the rise of childhood obesity involves advertising, primarily via television commercials.

One suggestion made by Harvard experts was that schools need larger budgets for physical education classes. Segments of the political spectrum are against it, though it seems obvious that kids need physical activity on general principles. For the sake of teachers and administrators, giving kids an outlet for their restless energy probably helps to keep classrooms more peaceful.

Kids need space and equipment for exercise — even if obesity reduction is not the targeted issue and even if no direct correlation between exercise and obesity is ever proven. Why? Because exercise is beneficial in 50 or more ways, depending on who is counting. Every one of those ways contributes indirectly to obesity reduction, because they are building blocks for a life that provides satisfactions greater than food.

The point is that parents can have a great amount of influence on school boards. On the local scale, becoming involved with the school system is an accessible route to making a difference. To be even more influential, always remember the power of example, especially when it is up close and personal — like at home, in front of the kids. Mahatma Gandhi said, “Be the change that you wish to see in the world.” And Jamie Oliver said, “When parents get angry, anything can happen.”

Your responses and feedback are welcome!

Source: “A Plan for Measuring Progress,” Institute of Medicine, August 2013
Source: “Kids are what they eat,” Harvard.edu, 09/26/12
Image by longislandwins

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