Childhood obesity a detour on child’s road to optimal health

As honorary chair of Partnership for a Healthier America, First Lady Michelle Obama has made the elimination of childhood obesity in one generation the central campaign of her Let’s Move! health initiative. The Centers for Disease Control and Prevention states that since 1980, obesity prevalence among children and adolescents has almost tripled, affecting 1-in-3 children in America.

Dr. Margaret Crittell is a board-certified pediatrician practicing at Pierremont Pediatrics. Crittell said, “In the United States, we have seen a dramatic rise in childhood obesity across all populations. Recently, there seems to be a slight glimmer of hope that some of the programs are working and the rate of rise is not continuing so dramatically. However, as this current children age, we expect to see a decrease in longevity due to the burden of disease associated with obesity.”

Crittell said, “Part of the problem with speaking about obesity is the terminology. The tool most people hear about with obesity is BMI, which stands for body mass index, and it is a ratio of their weight to their height. In children, we will say that they are overweight if their BMI is greater than the 85th percentile for their age and gender and obese if their BMI is greater than the 90th percentile.

“In the simplest terms, obesity is an imbalance of energy. Children are storing more than what they are burning, and that extra weight stored as fat begins to lead to additional problems. Because of many cultural changes not only inside the home but in the food industry, in schools and in how our neighborhoods are built, kids often have less access to free-play. This creates a sedentary lifestyle, which not only decreases the energy expended, but also sets kids up to be indoors with access to non-nutritious snack foods. If a child, or anyone for that matter, consumes just 100 extra calories a day above what they require for their growth and basic metabolic needs, at the end of a year, that is 10 pounds.”

According to the CDC, childhood obesity has both immediate and long-term effects on health and well-being. They claim obese children are more likely to have:

• High blood pressure and high cholesterol (risk factors for cardiovascular disease);

• Increased risk of impaired glucose tolerance, insulin resistance and Type 2 diabetes;

• Breathing problems, such as sleep apnea and asthma;

• Joint problems and muscular aches and pains;

• Fatty liver disease, gallstones and GERD; and

• A greater risk of psychological and social problems, which may continue into adulthood.

The CDC also finds that obese children are more likely to become obese adults later, which is associated with a number of serious health conditions including heart disease, diabetes and some cancers.

Crittell said, “First of all, parents need to talk to their child’s doctor and find out where they are on a standard growth chart. This should include measurements of height, weight and BMI. They need to have a clear understanding of where their child is and what their goal weight should be. Second, parents need to monitor their child’s food intake. A good way to control their intake is not to buy unhealthy, calorie-dense, non-nutritious food. And finally, parents need to get their kids moving. Not only will they burn more calories, but they often decrease their calorie intake because of the association of excess calories with sedentary activities. I usually recommend activities that will get kids’ heart rate up and make them breathe hard. Those are signs of calorie burning. An hour each day is the goal, but starting out at 30 minutes a day is great.

“In addition to the preventative steps mentioned above, I think parents need to be very proactive in helping their child lose weight, or to stop gaining weight too rapidly. Once a child is obese, the odds of them becoming a non-obese adult are not good. There are several programs around town that offer nutritional counseling, and I do refer parents and families to these. Making healthy meals and time for exercise are really the keys to long-term success.

“As a pediatrician, I want parents to know that we want our patients to enjoy good health, and we feel that obesity is a roadblock to optimum health. I hope that they will see the input from their child’s doctor as an objective measurement of one aspect of their child’s health, not as a criticism or judgment of their parenting skills. Only by working together and being honest can we help all children achieve their potential for good health.”