Baby fat is something children are supposed to outgrow, not grow in to. According to the National Center for Health Statistics 2009 to 2010, the percentage of young people who are overweight has more than tripled since 1980. Among children and teens ages 2 to 19 years, almost 17 percent are considered obese. Extra pounds and too-big waistlines have serious consequences for children, including self-esteem, social problems, and increased risk for chronic diseases. Why are so many children tipping the scales? Experts say there is no single cause of childhood obesity. Genetics plays a role, but too little physical activity and poor food choices are more often the culprits.
Too little activity
Anyone up for a breathless game of tag, kick-the-can, hopscotch? Childhood should be filled with hours of energetic play, but children today are less active than past generations. With more families living in cities, fewer children walk to school, and parents may keep children indoors more often out of concern for their safety. Adding to the problem, many schools have cut back on physical education programs. A national survey reported by the American Academy of Pediatrics (AAP) in 2003 found that 20 percent of children ages 8 to 16 in the U.S. are vigorously active only twice a week or less. Instead of getting the recommended 60 minutes of moderate activity a day, many children spend many hours a day watching television or playing video and computer games.
The AAP reports that more than 25 percent of all 8- to 16-year-olds watch at least four hours of television daily. Children who watch four or more hours of television per day are also more likely to be obese than children who watch less than two hours a day. A study published in the medical journal Pediatrics found that the rate of obesity rose 2 percent among 12- to 17-year-olds for every additional hour spent watching television. A study by the Harvard School of Public Health revealed that the risk of being overweight is more than four times greater in children who watch more than five hours of television daily compared with those who watch two hours or less. Just having a television in the bedroom is associated with being overweight, even in very young children. Inactivity is not the only problem with increased television viewing. Television exposes children to food commercials for high-calorie, unhealthy foods specifically targeted to them.
Our environment is loaded with food temptations. High-calorie foods are available everywhere a child turns: in school vending machines, at fast-food restaurants, at corner convenience stores, and even in kitchen cupboards at home. Fruits and vegetables are easily ignored in favor of high-calorie snacks, such as potato chips, cookies, candy, and sugary drinks. Hectic schedules mean home-cooked family meals are often skipped and replaced with less nutritious grab-and-go foods eaten on the run. Families eat out at restaurants more often, too, where portion sizes have ballooned, providing too many calories and too much fat.
Why you should be concerned
Being overweight or obese places a child at risk for many health problems. An obese child is more likely to develop type 2 diabetes, a condition that use to occur only in adults. According to the National Institutes of Health, there has been an alarming increase in diabetes among obese children and adolescents recently.
According to the CDC, obese children often have high cholesterol and high blood pressure, increasing their risk for heart disease. Children who are obese are more likely to have asthma and sleep apnea, a breathing problem that interrupts sleep, as well as bone and joint disorders. Overweight children are also more likely to become overweight adults.
The psychological stress that overweight children experience can be as devastating as the medical problems. They are often teased by other children and as a result suffer poor self-image, low self-esteem, and depression.
What you can do
Helping your children to have a healthy body weight is a family affair. Instead of putting the focus on the overweight child, the whole family should get involved in making healthy changes in activity and eating habits, experts say. As a parent, you are the most significant role model for your children, so it's important that you set an example with healthy lifestyle habits.
Check with your pediatrician about current screening recommendations for children and teens. Because of the immediate and long-term risks of being overweight or obese, the AAP now recommends that all children--regardless of family history--be screened for high cholesterol between ages 9 and 11, and again between ages 17 and 21.
Get up and move:
Physical activity is a great way for you to spend quality time with your children. Emphasize the fun of an activity rather than skill.
Build family activity into every day, perhaps taking an after-dinner walk or bike ride or dancing to fast music in the living room.
Plan active family outings, such as hikes, ice-skating, swimming, or playing Frisbee. Try a family vacation that emphasizes canoeing, bicycling, camping, or swimming.
On birthdays, give presents that encourage activity, such as a jump rope, pogo stick, bicycle, in-line skates, or a basketball.
Set guidelines for how long your children can watch television or play computer or video games. Limit children to 30 minutes or less per day in-front-of-the-screen activity whether TV, video game, or computer (homework is an exception). Allow younger children to choose one half-hour program.
Choose healthy foods:
Use the Choose My Plate plan as a guide for food choices. Serve fruits, vegetables, whole grains, beans, and lean meats and poultry. Use low-fat or nonfat milk products (except for children younger than 2 years old).
Keep healthy snack foods in the house, such as fresh fruit, vegetables, and low-salt and low-fat pretzels.
Don't purchase high-fat, high-sugar, or high-calorie snacks. If they aren't in the home, you won't be tempted to eat them yourself or distribute them to your children.
Have your children start the day with a filling breakfast, such as whole-grain cereal with fruit and low-fat milk, whole wheat toast, or a fruit smoothie made with low-fat yogurt.
Involve kids in shopping for and preparing meals. Children like to eat what they've helped prepare. At the grocery store, stick to the outer aisles where the healthiest options, such as fruit, vegetables, dairy, and whole grains, can be found. Don’t take them down the candy or snack food aisles.
Don't keep unhealthy foods in the house. Teach your children about convenient, healthy foods that can be eaten every day.
Children are more likely to make healthy changes when they feel good about themselves. Help your children find things to do that make them feel valuable. It might be community volunteer work, visiting the elderly neighbor down the street, helping Grandma clean her yard, or pursuing a special interest such as art or music. Point out your children's strengths and help them develop their own interests and abilities.
If you're concerned
If you're concerned about your child's weight, first talk to your pediatrician or family doctor. Your child's doctor can determine whether your child is at a healthy weight by calculating his or her body mass index (BMI). BMI, a ratio of weight to height, is considered the best method for evaluating weight in children. According to the AAP, a child with a BMI between the 85th and 95th percentile for age and sex is considered at risk of being overweight, and a BMI at or above the 95th percentile is considered overweight or obese. (You can find an online BMI calculator at the CDC website.) Your pediatrician will compare this number with a growth chart for children of your child's same age and sex.
Your pediatrician can help you identify appropriate weight management goals for your child. Often, the goal isn't to lose weight, but to change behavior. Restrictive diets are not recommended for overweight children. Rather, the goal is to help them maintain their weight as they grow taller and eventually become leaner. Another approach is to help a child burn more calories by being more physically active. A registered dietitian can provide guidance on eating behaviors, meal planning, and shopping. If your child is at risk for medical problems, your doctor may recommend a formal weight management program staffed by a team of health professionals, such as a pediatrician, dietitian, and psychologist.
Most important, let your children know that you love them, regardless of their weight. Give your children plenty of support and approval. Helping to build your children's self-esteem is a great way to help them to develop healthy new habits.