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childhood obesity a
growing epidemic
There is no simple answer for
childhood obesity.
I don't know what to do about Ashley, my
9-year-old daughter," one of your clients confides. "She's always
been sort of chubby. Her doctor's a little concerned, but the big
problem is the teasing she gets from the other kids. Here she is, 9
years old, and starting to worry about her weight. Sometimes I see
her frowning at her reflection in the mirror. I wish I knew how to
help her without making her more self-conscious about her
appearance."
There is no magic answer for childhood
obesity. With obesity rates on the
rise, we know obesity in childhood is a serious problem that can't
be ignored. On the other hand, if we worry our children with diets,
deprive them of the sweets they love and force them to participate
in sports programs they hate, they may simply reject everything we
say and do, or develop disordered eating and exercise behaviors.
What's a mother (or father, teacher or exercise instructor) to do?
Why the high prevalence of childhood obesity?
Surveys suggest that 15 to 25 percent of children in the U.S. are
obese.1, 2 It is not surprising that obesity is a problem for
children, since it is a problem for their parents as well.
After all, the same genetic and environmental factors responsible
for adult obesity operate in childhood. Many people are genetically
prone to obesity. Some infants, for example, are born with lower
metabolic rates. Some children are less active than others and,
thus, burn fewer calories. Add plenty of delicious, high-fat food,
and risk for obesity increases even more.
Sedentary habits are also to blame. A positive relationship exists
between television viewing hours and obesity. When children watch
television, not only are they inactive, but they are likely to be
snacking as well. While most younger children are inherently active,
school-age children must learn to sit still. Many schools do not
provide children with adequate opportunities for physical activity;
either not enough time is spent on physical education or the
programs are not appealing, especially to those who need activity
the most. Once a child learns that physical activity is unpleasant,
activity level declines even further. |
Prevalence of childhood obesity.
Obesity and
associated health risks.
Fight obesity with
physical activity.
Adults as role
models.
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Obesity health risks
Aside from the teasing, is childhood obesity a serious health
problem? Although the real health problems associated with obesity,
such as diabetes, hypertension and heart disease, do not usually
develop until adulthood, the process of atherosclerosis begins early
in life. Obese children tend to have higher blood pressure and
higher blood cholesterol levels than children of normal weight,
which can develop into health problems down the road.1 Fortunately
many children "outgrow" obesity. Only about 40 percent of obese
children develop into obese adults.2
Physical activity: A positive approach for prevention and treatment
Physical activity is the first line of defense against obesity.
Children need opportunities to be active. Physical activity confers
numerous health benefits and is essential for everyone, not just
children and adults who are overweight. Young children are
inherently active; older children will remain active if given
encouragement and plenty of opportunity. Encouraging activity
provides a positive approach to weight control, as long as the
activities are perceived by the children to be pleasant and fun.
On the other hand, traditional dietary restrictions tend to be seen
by children as unpleasant and unfair. Children should never be "put
on a diet." They should be given wholesome, nutritious food. If
possible, the adults in charge should never make an issue of
limiting fats and sugars, even as they are doing so. By simply
providing delicious, nutritious meals and snacks, adults can limit
empty calories and fat calories in a reasonable way without making
the obese child feel penalized. Obviously, occasional treats must be
enjoyed, especially in social situations. If everyone else at the
party is eating birthday cake and ice cream, this is not the time
for denial. |
Good nutrition is essential for optimal growth and development in
childhood. A diet based on the Food Pyramid that contains 30 percent
of its calories from fat appears to be adequate for normal growth.
Children who are only moderately overweight may "grow into" their
weight, using some of their stored energy for growth.2
Adult role models: Walk your talk
Children learn more by example than by instruction in the early
years. When parents and caregivers model healthful exercise and
eating habits, these habits trickle down to the children under their
care. During the early years, parents and caregivers also set the
rules and buy the food, and can take advantage of their station to
lovingly promote healthful lifestyles (I'm the mommy, that's why.).
A helpful household rule can be that all eating is done while seated
at the meal table. This eliminates mindless snacking in front of the
television. Portions can be given on plates; this helps prevent the
whole bag of chips from being consumed in one sitting.2 Limiting
television time is common among many families.
Most important of all are the caregivers' attitudes toward exercise,
food and weight, not to mention life in general. Young children seem
to have a sixth sense in this regard. If you are looking forward to
your morning walk, they want to come along with you. If you are
stressed out about your weight, children will sense the problem. No
words need to be spoken.
Obese children often have parents who are struggling with weight
problems themselves. These struggles can spill over into the child's
life; parents want children to succeed where they themselves have
failed. Weight control issues take on a larger, more emotional
meaning as children try desperately to meet the expectations of the
parents they love. It is unfortunate that in our culture thinness
symbolizes goodness, so overweight children begin to believe that
fatness means they are not good. Parents and caregivers must fight
this powerful cultural message that can be so harmful to a child's
fragile self-esteem. Body size and goodness must be separate issues.
For many parents and caregivers, food symbolizes love. After all,
giving food is part of nurturing. Some parents express their love by
giving high-fat treats. It is possible, however, to show love in
other ways. Give hugs and kisses, spend time with the child doing
something you both enjoy, develop a hobby together. You can deny
treats without denying love.
REFERENCES
1. Parker, D.F., & O. Bar-Or. Juvenile obesity. Physician and
Sportsmedicine 19(6): 113-125, 1991.
2. Wardlaw, G.M., P.M. Insel, & M.F. Seyler. Contemporary Nutrition:
Issues and Insights. St. Louis: Mosby, 1994.
Barbara A. Brehm, Ed.D., is professor of exercise and sport studies
at Smith College, Northampton, Mass.
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Healthcare professionals are urging
childcare providers to
prevent obesity through nutrition and fitness education.
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