The prevalence of overweight children has tripled
between 1985 and 2000 and has reached epidemic proportions, with
approximately 16% of children currently classified as overweight. A
child is considered overweight if his/her body mass index (BMI; [wt
(kg)/ ht (m)2]) falls between the 85th and 95th percentile for his/her
gender and age. A child would be considered obese if his or her BMI for
age is > 95th percentile.
About 50% of overweight children
become obese adults. Children are not aware of the long-term health
risks associated with being overweight. For example, paralleling the
increase in the numbers of children classified as overweight, there has
been a drastic increase in childhood type II diabetes. In addition, a
variety of other physical complications (e.g., orthopedic concerns,
high blood pressure, sleep apnea) and psychological problems (e.g.,
depression, anxiety, loneliness, low self-esteem) are often associated
with being overweight.
There are several reasons for the dramatic
increase in the prevalence of overweight children.
1. The
environment has played a major role. Children are exposed to a variety
of easily accessible and affordable fast food options in the community,
vending machines stocked with sugar-sweetened beverages at school, and
high-calorie snacks at home. Clearly, changes need to be made in all of
these settings.
2. Advertising has also played a major role.
Dr. Kelly Brownell, director of the Yale Center for Eating and Weight
Disorders, noted that the US government nutrition education program ("5
a Day") was given $3 million for promotion, while the fast food
industry spends 1000 times that in advertisements geared towards
children. Accordingly, Brownell stated that Ronald McDonald is the
second most recognized figure in the world, just after Santa Claus!
3. Portion sizes have increased considerably. For instance, soda used to
be sold in 6 oz. containers. The standard size is now 20 oz! Every day
children get 11% of their calories from soft drinks, which is about 15
teaspoons of sugar per day! Our society is filled with buffets, big
gulps, and super-sized portions.
4. Eating patterns have
changed. People now eat more meals outside the home, consume fewer
fruits and vegetables, and make more hi-fat choices.
5. Activity levels have decreased. Twenty years ago, children engaged in
several bouts of physical activity per day. Now, many schools have
removed physical education from the curriculum and children are
replacing after-school physical activity with television, computers,
and video games.
Preventing and Treating Childhood Overweight
Behavior modification programs are effective at addressing a variety of
problematic behaviors, but they are nevertheless challenging.
Fortunately, it is easier to change a child's behavior than that of an
adult. Family-based interventions aimed at targeting specific behaviors
(e.g., television viewing, physical activity, diet, consumption of
sugar-sweetened beverages) are most promising. Below are some ways that
you can help your family increase their healthy behaviors:
- Make
family time an active time. The summer is coming - go for walks, ride a
bike, take a swim. Reduce television and video game time. Instead of
sitting on the couch, try walking around a museum, garden, or mall.
- Use physical activity as a reward for good behavior. But, don't
take it away as a means of punishment (e.g., "no playing outside
today"). The end result would be more sedentary behavior for your
child.
- Plan and prepare healthy meals together as a family. Start
eating breakfast to provide the fuel you need for the day. Research
shows that kids who eat breakfast miss fewer school days, are late less
often, do better in school, and are more alert.
- Make healthier choices. Choose whole grains, various fruits and
vegetables, skim or 1% milk, lean meats, and select healthier cooking
options (e.g., baking, broiling). Snacks are important for a healthy
diet. Try to select low-fat, reduced sugar, and reduced salt snacks.
- Drink more water. Try adding different fruits to the water to
give it a fruity, summery taste. Be careful with juice drinks; many do
not have real fruit juice and are actually high in sugar. Select one
that says "100% juice."
- Be a role model and practice what you preach. Make sure that
your portion sizes aren't "super-sized," that you choose water and
healthy food options, and that you do not take the sedentary way out.