I have devoted increased time over the last two years learning about management of traditionally adult conditions such as high blood pressure and high cholesterol levels that are now appearing with greater frequency in the children seen in our endocrine clinic at Cook Children’s.
In January of 2010, the World Health Organization released its findings from surveys done between 2000-2008 on world-wide obesity rates which stand as a direct indicator of a nation’s nutritional trends, health and culture. Shocking as it may be, the U.S. holds the No. 3 slot with an astonishing 66.7 percent of its population considered medically obese, landing only ahead of the small island nation of American Samoa and one of its territories. It is estimated that we will spend $150 billion dollars this year to treat obesity in this nation.
The most current information on U.S. adult obesity from the Centers for Disease Control is shown on the map below. Adult obesity ranges from the lowest prevalence in Colorado of 1 person out of every 5-6 people to a high of nearly 1 person out of every 3 in Alabama. Texas sits at the sixteenth spot for obesity with a prevalence of 1 person out of every 3 to 4 people.
Children in the U.S. haven’t fared much better than adults. The prevalence of obese children has tripled over the last thirty years. The percentage of obese children stands at a bit over 16% or roughly 1 child out of every 13. Nearly all of the factors leading to the rise in adult obesity underlie the rise in childhood obesity. Most people are already aware of the health risks of obesity which include conditions such as:
- Early heart disease and heart attacks
- High blood pressure
- High cholesterol
- Obstructive sleep apnea
- Degenerative arthritis in hips and knees
The startling news is that these same conditions, particularly type 2 diabetes, are increasingly diagnosed in obese children, a relatively new phenomenon. At Cook Children’s, we now have to learn how to treat children with historically adult conditions based upon adult treatment guidelines because there is little to no past experience with these problems in the pediatric specialty.
The imperative to prevent as well as manage obesity in childhood arises from concern that obesity will not only negatively impact children’s physical and mental health, but may ultimately shorten their life span. To be expected, there is controversy within the medical community as to whether this is a true possibility. Data from research study related to this very concern was published recently in the New England Journal of Medicine, and the results from this study spanning twenty-four years are sobering. The study followed a group of Native Americans from childhood into adulthood. The rates of death from natural causes before age 55 was more than double in those who were most obese when compared to those who were least obese in the population.
No parent relishes the notion that their child is ‘fat.’ As individuals, we have different views about body image. So rather than compare your child to another, the first step for any parent should begin with understanding the medical definition of childhood obesity. Childhood obesity incorporates height and weight guidelines, as well as accounting for the normal differences in body fat and age variances between boys and girls.
A BMI calculator (Body Mass Index) will help you begin the process, to see if your child falls into the category of being obese or overweight. While this is a very useful tool, it is important to note that BMI correlates with the amount of body fat. It is not a direct measurement of body fat, which is difficult to discern. This is why a high performance athletes like tennis champ Serena Williams would be identified as overweight even though she does not have excess body fat. Other ways of determining body fat and body fat distribution would include skin-fold thickness, waist circumference, calculation of waist-to-hip circumference ratios as well as ultrasound, computed tomography, and magnetic resonance imaging (MRI).
The next step is taking necessary action. The good news is that there are numerous programs and approaches to prevention and treatment of childhood obesity. Most every approach has common elements of food choices balanced with an active lifestyle, limiting television and computer time and eating together as a family.
I’d be remiss to not point out that there is positive news to offset the negative reports. An encouraging study, published in the Journal of the American Medical Association in 2010, found that overweight and obesity rates across the U.S. appear to be leveling off, though still a long way from where they should be. And, two inspiring people in particular have emerged as warriors against this prevalent malady. First lady, Michelle Obama, has launched a program targeted at preventing childhood obesity and to raise a healthier generation of children called Let’s Move. Mrs. Obama’s program shares many similarities to the Healthy Active Living program of the American Academy of Pediatrics.
From across the Atlantic, British celebrity chef Jamie Oliver has been recognized in his country for several years for his continued efforts to combat childhood obesity. He has appeared recently on US television in the ABC series Jamie’s Food Revolution. Chef Oliver’s approach resonates with my own personal passion for healthy cooking and eating.
I wish you and your family good health.