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Understanding childhood obesity

By: David Ludwig, MD, PhD, director of the Optimal Weight for Life (OWL) program at Children's Hospital Boston

The prevalence of obesity among children in the United States increased by 100 percent between 1980 and the mid-1990s. Being overweight brings serious health concerns for children, including diabetes, high blood pressure, high cholesterol levels and orthopedic problems, such as increased stress on joints. Self-esteem also often decreases when children are overweight.

Why are more children overweight?
Genetic factors play a role in a child's risk of being overweight, but obesity rates have tripled in the past 30 years, while genes have not changed.

In other words, genes are not the problem for the vast majority of people. Instead, two-thirds of obesity would vanish if society could revert to the way it did certain things 40 years ago. Environmental factors that have changed since then include:

• What we're eating
• How active we are
• Our family structure

What we're eating
Fast food was eaten maybe once a month on special occasions or as a treat in the 1950s. Now, most children in the United States have fast food at least once a week, and it's served in enormous portion sizes. Fast food has a tremendous number of calories per bite, and no fiber, so it can be chewed easily and consumed quickly before the body has time to register that the calories are coming in. By the time the body registers that it is full, too many calories have already been consumed

Typical fast food meals are high in refined starch and added sugar. They also have a high glycemic index, which refers to the rise in blood glucose that occurs after a person eats foods containing carbohydrates. High glycemic diets have been associated with an increase in insulin levels and may contribute to excessive weight gain. Some studies have shown that high glycemic load meals increase hunger and make a person want to eat more throughout the day.

To help prevent becoming overweight, children should eat less fast food. Overall, they should eat less refined grains and concentrated sugars, and more low glycemic index foods—fruits, vegetables, beans, nuts, unprocessed grains, adequate protein, and healthful oils such as olive oil, avocados, nuts, and omega 3 fats—that leave a person feeling filled longer.

Soft drinks are another likely reason for increased childhood obesity. In the 1950s, children had three cups of milk for every one cup of soda. Now that has reversed.

Similar to eating calorie-laden fast food, when a person drinks soda—which is 100 percent sugar—it may escape the body's weight regulating systems.

One study found that every additional serving of soda per day increased a child's odds of becoming obese by 1.6 times.

How active we are
Instead of playing outside, children are watching a massive amount of television, which is clearly linked to obesity. And while children are watching television, they are:

• Not exercising
• Eating junk food
• Being inundated with advertisements for some of the unhealthiest foods

Children and teenagers who watch several hours of television a day have less opportunity to develop the athletic skills and love of physical activity. Unfortunately, many schools are cutting back on physical activity and physical education programs. This gives children even less opportunity to get exercise, become more confident in their athletic abilities, and develop an interest in sports or in being active.

The family structure
The third contributing factor to the obesity epidemic is that there's too much stress on families these days.

Forty years ago, families cooked dinner and sat and ate it together on a regular basis. Too often now, dinner is grabbed from a fast food restaurant and eaten on the go.

It's important to set a good example for your children by being active yourself and planning family activities such as biking, hiking, running, walking, swimming or skating.

There's no alternative to a parent cooking a dinner and eating it with his or her children, and taking them outside to play. The answer to the obesity problem is very simple. We need to return to more traditional ways of eating, exercising and being with our families.

This article was adapted from content provided by Children's Hospital Boston to the Health and Parenting sections of Yahoo! For more pediatric health information from Children's, visit http://health.yahoo.com, and select "Parenting" under Our Centers:Healthy Living.

Copyright ©2005, Children's Hospital Boston. All rights reserved.

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