Fighting Childhood Obesity

There’s no denying the grim statistics on childhood obesity in America. The condition is spiraling out of control, posing major health risks for our nation’s youth. According to the American Obesity Association, Washington, D.C., obesity rates have quadrupled over the past 25 years. Approximately 30% of children ages 6 to 11 are overweight and 15% are obese; 30% of adolescents ages 12 to 19 are overweight, and 16% are obese. (In children and adolescents, overweight is defined as 85th percentile for BMI, and obesity is defined as 95th percentile for BMI.) Along with this data comes myriad health concerns, as overweight kids experience increased morbidity and mortality rates into adulthood. They are at risk for asthma, hypertension, type 2 diabetes, orthopedic problems, psychosocial difficulties and sleep apnea.

The blame game 

Who’s to blame for the weighty problem of our country’s youth? Researchers have been exploring a number of issues and their relationship to childhood obesity, including genetic factors, soft-drink consumption, physical inactivity, television viewing, school foodservice, fastfood consumption, vegetable and fruit consumption, and parent modeling. What it all boils down to is that families and schools are both critical links in educating children about healthy behaviors for eating and physical activity.

Schools are in the middle of a renaissance when it comes to how they provide food and nutrition to students. Thanks to the 2004 Child Nutrition and WIC Reauthorization Act, U.S. schools developed local wellness policies that addressed nutrition education and physical activity. Schools in several states are moving forward to ban soft drinks on campus, and some are initiating school garden programs that create a better understanding of nutrition and agriculture.

Physical inactivity is a big part of the obesity problem. According to a 2005 Centers for Disease Control and Prevention (CDC) Youth Risk Behavior survey, only 35.8% of students were physically active for 60 minutes or more per day on five or more days each week. The amount of time kids are plugged in seems to affect their weight, too. In a school-based trial published in the Journal of the American Medical Association (1999; 282(16):1561-7), students who underwent a six-month classroom curriculum to reduce television, videotape and video-game use experienced statistically significant decreases in body mass index (BMI).

Primer on children’s diets 

So just how bad are the diets of America’s kids? For starters, sheer caloric intake has climbed from an average of 1,876 calories for Americans (including children and adolescents) in 1977 to 1978, to 2,043 calories in 2005. With a swell in soft-drink consumption and portion size in quick-service and casual dining, it’s easy to see how calorie levels have escalated.

According to a 2002 analysis of the National Health and Nutrition Examination Survey (NHANES III), children ages 5 to 10 eat highfat, nutrition-poor foods for snacks and at mealtimes. The data show that 75% are eating more fat than the recommended maximum of 30%, while 10% are getting only half the daily reference intake (DRI) for vitamin C, and 75% are not meeting the DRI for potassium, USDA data also shows that less than 15% of elementary school–age children eat the recommended five or more servings of fruit and vegetables each day, and that 71% of girls ages 6 to 11 and 62% of similar-aged boys do not meet their calcium recommendations. According to a National Cancer Institute analysis in 1997, only 1% of children between ages 2 and 19 met all the recommendations for grains, vegetables, fruits, meats and dairy foods.

The ABCs of good nutrition 

The importance of kids learning healthy eating habits is paramount in the war against childhood obesity. But the same rules of adult weight loss don’t apply to the child population, as severe caloric restriction might compromise growth, delay the onset of maturity and cause emotional problems related to eating. The general goal for overweight children is to maintain weight or reduce the rate of weight gain so the percentage of body fat can gradually decline as the child grows. The 2000 CDC Growth Charts and the New Body Mass Index-For-Age Charts are useful for health practitioners in evaluating children’s weight. Morbidly obese children can be managed more rigorously by health-care practitioners.

Health experts emphasize positive dietary habits to help control weight, minimize the risk of chronic disease and promote behavior change within the entire family. Recommendations include: focusing on portion size; reducing fats and sugars in food preparation; using MyPyramid as a guide for healthful eating; limiting high-caloric, non-nutritive beverages; avoiding foods rich in refined carbs and fats; and consuming lean protein, whole grains and cereals, as well as legumes, fruits, vegetables and low-fat dairy products.

Kid-friendly foods 

The Institute of Medicine (IOM) released a report entitled “Food Marketing to Children and Youth: Threat or Opportunity?” in 2005 that found food and beverage companies spend about $10 billion per year marketing youth food products, most of which are high in calories, fat, salt and added sugar, and low in nutrients. The IOM called upon the food industry to create and market healthier foods aimed at kids. In 2006, the Federal Trade Commission and Department of Human Health Services joined in by releasing “Perspectives on Marketing, Self-Regulation and Childhood Obesity” (http://www.ftc.gov/os/2006/05/PerspectivesOnMarketingSelf-Regulation&ChildhoodObesityFTCandHHSReporton-JointWorkshop.pdf), a report recommending specific steps the industry can take to help fight childhood obesity, including: creating new products that are lower in calories and are more nutritious; controlling portion sizes through packaging; exploring labeling initiatives to identify lower calorie, more nutritious foods; and marketing more nutritious food choices. The American Heart Association recommends caloric needs by age: 900 calories per day for 1-year olds; 1,000 calories per day for ages 2 to 3; 1,200 to 1,400 calories per day for ages 4 to 8; 1,600 to 1,800 calories per day for ages 9 to 13; and 1,800 to 2,200 calories per day for ages 14 to 18.

The food industry quickly responded to the call. A number of food companies have pledged to make their foods healthier, such as General Mills’ strategy of putting whole grains in every box of its cereal. And that’s just the beginning. Calorie-control packs marketed at kids are a popular method of providing calorie-controlled options, compared to a bottomless bag of potato chips. The Sensible Solution program developed by Kraft allows a product to carry an easily recognizable symbol if it meets specifications for reduced calories, sugar and fat, and if it provides beneficial nutrients.

A number of new, lean, nutrient-dense food products for kids are popping up all over supermarket shelves. Funster Mashed Potato Letters, Funster Natural Foods, Inc., London, Ontario, Canada, offer a healthier alternative to fried french fries. Bare Fruit, Omak, WA, makes snacks that are 100% organic, baked-dried fruit with 29 calories per 0.42-oz. serving. And Stonyfield Farm, Londonderry, NH, markets YoKids organic, low-fat yogurt, which has one gram of fat and 110 calories per serving.

The news is bright for food companies interested in investing in America’s youth. 

Sharon Palmer is a registered dietitian with 1 years of experience in health-care and foodservice management. She writes on food and nutrition for newspapers, magazines, websites and books. Palmer makes her home in Southern California and can be reached at [email protected].