Tuesday, October 20, 2009

Combating Childhood Obesity

Childhood obesity is not only present in the USA, but worldwide! About 20 million children under the age of 5 around the world are classified by the World Health Organization as obese.

Some time ago I was asked to give a talk to teens from Japan. The gist of my message was to compare Japanese and North American food intakes and encourage these youngsters to keep to their excellent, traditional eating habits for a healthy weight. I prepared the handouts and presentation carefully as the translator would be repeating everything I said. Much to my surprise, at least half of the children in the audience were overweight. It seems the studies that have been published recently were manifesting themselves right in front of me. Japanese children are adapting North American eating habits as fast food chains have appeared in full force in their neighborhoods. Eating at these fat factories has become fashionable and the social “in” place for meeting friends. The Japanese population is going to go through the same problems of obesity that we have here.

They’re not the only country at risk. In an editorial in the Journal of the Indian Academy of Pediatrics, the majority of India’s citizens are undernourished; yet many of the wealthy Indians are suffering from obesity. And in other countries that suffer from malnutrition, such as Mauritius and Western Samoa, overweight is increasing. In the US, the rate of obesity in children has doubled in the past decade.

In my practice, I counsel many children who come to see me because their parents are concerned about their weight. Mothers and fathers want their children to lose weight because their child:
• Doesn’t want to go to school;
• Won’t wear a bathing suit;
• Doesn’t want to participate in activities;
• Was sad, depressed or upset;
• Couldn’t wear fashionable clothes;
• Didn’t want to socialize;
• Were cruelly teased;
• Were closet eaters – sweet papers were found under their beds.

Fortunately I haven’t seen children being forced to look “model slim” due to obsessive parents who have their own weight issues.

Why should children aim for a healthy weight?

There are many reasons to learn good eating habits as a child. The two main ones are:

1. Health: diabetes is now being seen in children. Later in life, the risk for heart disease, some cancers and many chronic diseases will increase with obesity. Recently Swedish researchers said people who were obese at the age of 18 are twice as likely to die prematurely compared to those who were normal-weight teenagers.

2. Self-esteem: it’s tough enough in this world without losing confidence for being overweight. At another talk, one of the audience members asked me “Is it worth it to struggle your entire life to keep a healthy weight?” I said, “You either struggle or get fat. There is no choice.” Actually, when I’m under control, I feel very strong and don’t feel like I’m struggling, it’s when I’ve lost control and am overeating everyday, that it’s a struggle to turn it around again. Hopefully, we can help your children turn it around and see the benefit of making good food choices.

But first, we need to know why your child is overweight. What causes obesity?

Genetics: Some families are naturally lean. They don’t think much about food and have an inherent signal that tells them to stop eating when they’ve satisfied their hunger. We’re not talking about these freaks (you can tell I’m a genetically obese type); we’re talking about the numerous families that have to focus on good eating habits, and stay focused to prevent excessive weight gain (yup, that’s my family).


• Food: Temptation from the fast food outlets beckons us; the wonderful assortment of pastries on every street corner, the ice cream in the fridge, the chips and cookies in the cupboards are magnets to us. Even soda is a problem. A recent study published in The Lancet medical journal found a soft drink-obesity link in children. If they increased their daily soft drink intake, each extra soda made them 60 percent more likely to become obese, regardless of how many sodas they were drinking before.

• Lack of activity: Being inactive is well known as a cause of obesity. Watching too much television and playing computer games result in obesity, poor body image and decreased school performance, according to a study in Pediatrics. How do we help our overweight children? It is widely accepted that overweight or obese children have a greater risk of growing up to be overweight or obese adults. We need to start some steps to get their weight under control while young.

Some tips:
• Try not to nag, rather encourage.
• Have your children copy you. Set a good example by eating well and being active.
• Do not weigh them, you can tell by the way their clothes fit if they’re losing weight.
• Work with them to maintain their weight as their height increases. This is not the time for crash diets that could stunt their growth.

In the food arena:
• Involve your children in making a shopping list with nutritious foods.
• Keep only nutritious foods at home. Having unlimited sweets, chips and cookies around leads to unconscious eating – the type that leads to weight gain.
• Cook enough for the family for one meal. If you cook too much, put away leftovers.
• Let your children help in the kitchen.
• Eat out at ethnic restaurants so children can learn to enjoy different flavors.
• Allow children to stop eating when full - avoid the "clean plate" syndrome.
• Keep washed fruit and prepared vegetables in the fridge for snacking any time.
• Have them drink milk, water and natural fruit juices rather than soda.
• When eating out, let them enjoy a treat.

With activity:
• Encourage exercising, athletics or playing with friends.
• Keep them away from foods with hobbies like singing, reading, volunteering and community activities.
• Remove television sets from children’s bedrooms. Limit children's total media time to no more than 1 to 2 hours of quality programming per day.
• Record high-quality, educational programming for children.
• Limit computer game time to 30 minutes per day.
• Try computer games that encourage activity.
• Talk, play, sing and read together.

Find a dietitian at www.eatright.org to help you with your efforts.

Recommended book: The Mom’s Guide to Meal Makeovers by Janice Newell Bissex and Liz Weiss.

It’s hard, but if we all make a small effort, perhaps we can improve the health and self esteem of our future adults.