Dr. Randi B. Nelson: There’s Been a Decrease in Childhood Obesity – Let’s Continue the Trend


By Randi B. Nelson MD, MBA

GOOD NEWS! Recent studies, including reports from the Center for Disease Control and Prevention, have shown an encouraging trend in childhood obesity. The obesity rate has either declined in many states or remained steady in others.  Increased awareness including grassroots initiatives to encourage healthier lifestyles, and federal programs like the “Let’s Move” campaign, a comprehensive and coordinated initiative to combat childhood obesity launched by First Lady Michelle Obama in February 2010, are behind this trend.

However, much more can be done!

What initially lead to the epidemic? What are the risk factors?

Let’s quickly review some of the causes of the present epidemic.  There are several reasons. More families are dining out or consuming fast food due in part to busy schedules. In general, children and adolescents are eating more meals away from home, drinking more sugary drinks, and snacking more frequently. Additionally, increase in “screen time” activity i.e. video, smart phone and tablet usage occupies a large percentage of a child’s leisure time, which influences their physical activity levels. It is estimated that children in the United States spend 25 percent of their waking hours watching television and statistically, children who watch the most hours of television have the highest incidence of obesity.  Additional risk factors include family history; a child is more inclined to be overweight or obese if other family members are overweight or if the groceries purchased for the home consist primarily of high calorie foods.

How does obesity harm?

It is vital to understand the complications of obesity. Childhood obesity can lead to a myriad of problems especially if obesity extends into adulthood. Some of the physical complications include type II diabetes (an increasing number of teenager have this type of diabetes), high blood pressure, bone and joint disorders, and respiratory problems, such as asthma. They may suffer from sleep apnea, which is a breathing disorder characterized by brief interruptions of breathing during sleep. It occurs when the throat collapses during sleep causing the child to snort and gasp for breath. Children may incur early onset of puberty or menstruation due to hormonally active fat cells. Obese children are also more prone to fatigue, which can result in poor academic achievements. Emotionally, these kids are likely to be teased or bullied. This can lead to poor self esteem which can then lead to behavioral and/or learning difficulties.


What can be done to prevent this?

Of course genetics play a role and little can be done about that. However, obesity occurs in large part to eating habits and the amount of physical activity incorporated in the day.  The good news is that you have the power to make appropriate lifestyle and dietary changes. Prevention can be broken down into two main parts:

Healthy eating habits: Incorporate fruits, vegetables and lots of WATER into the diet. Increased intake of fruits, vegetables lessens the appetite for sweets and junk foods. Substituting water for sodas and processed fruit juices, which contain a great deal of sugar and calories, keeps you hydrated and full. Make sure your child has breakfast every morning and it can be as simple as a hardboiled egg with whole grain toast, fresh fruit, plain yogurt with added fresh fruit or my personal favorite – fresh fruit and veggie smoothies that is easy to make in a blender. Limit the number of times you eat out, especially at fast-food restaurants. However, if you do, take note of the many healthy, low caloric entrées many restaurants now offer and also note the nutritional information on menus such as calories and fat content, which will assist you in making the right meal choices. More importantly, do not buy nor keep cookies, potato chips and junk foods in your home. If it is present, everyone in the household will consume them especially your children. Healthy eating habits should be a family endeavor, make it a family affair!

Physical Activity: Try to get a total one hour of physical activity everyday and this can be accomplished throughout the day and begin with small increments of say 15 minutes. Choose activities that are enjoyable for the entire family. It’s a great way for the family to spend time together while encouraging fitness. Any type of activity counts including walks in a safe environment, dancing around the living room as well as hula hoops and jump ropes which can be done in any space including an apartment.  The activity does not have to be structured or accomplished in a gym. Activities such as hide and seek and tag are great for burning calories and improving fitness.

Also, turn off the TV, computer games or the computer itself. The American Academy of Pediatrics recommends no more than 1 to 2 hours each day of total screen time, including TV, computers and video games; use the free time for more physical activities.  Encourage and collaborate with school officials and insist that physical education be reinstituted in the school, if it is no longer available.

Small changes can yield significant results over time. The decline in childhood obesity is sustainable if we make a conscious effort and investment in healthy eating habits and exercise.

Dr. Randi B. Nelson M.D. MBA is a Board Certified physician in Pediatrics. She is a native New Yorker who now lives and practices in the East Bay of San Francisco.

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