A new study suggests that the epidemic of childhood obesity finally may be leveling off. (Matt Slocum/Associated Press)A glimmer of hope has emerged in the battle against childhood obesity. As I wrote about in today’s Times, the Centers for Disease Control and Prevention is reporting that childhood obesity rates appear to have hit a plateau.
Nobody is celebrating just yet. Now health officials and families need to focus on helping the one out of three children in the United States who are already overweight or obese. Fortunately, the problem is potentially easier to battle in children than adults.
“Childhood is the ideal time to address this problem for a lot of reasons,” said Dr. David Ludwig, director of the child obesity program at Children’s Hospital in Boston. “The lifestyle habits that cause the problem haven’t been entrenched as long with children as they have with adults. And all but the most heavy children can basically outgrow their problem by holding their weight constant as their height increases or at least slow their rate of weight gain.”
Because kids are constantly growing, it can be tough to figure out how much your child should be eating. They key is to provide a ready supply of healthful foods and limit so-called “energy dense” foods — things like fried chicken nuggets or pastries that pack a lot of calories in each bite.
A number of Web-based tools can also help. The Children’s Nutrition Research Center at the Baylor College of Medicine provides an energy calculator that can help you determine how many calories your child should be eating each day. To use the calculator, click here.
To find out whether your child is at a healthy weight or at risk of being overweight, you should use a childhood body mass index calculator. The C.D.C. provides one here. And click here to learn more from the C.D.C. about using B.M.I. calculations in childhood health.
Healthy living doesn't happen at the doctor's office. The road to better health is paved with the small decisions we make every day. It's about the choices we make when we buy groceries, drive our cars and hang out with our kids. Join columnist Tara Parker-Pope as she sifts through medical research and expert opinions for practical advice to help readers take control of their health and live well every day. You can reach Ms. Parker-Pope at 
The easiest and most pleasurable way to eat well is to cook. Recipes for Health offers recipes with an eye towards empowering you to cook healthy meals every day. 
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A picture is worth thousands words….
— therese Le MignonThis little girl is holding hands with 2 overweight adults…..WHO is going to guide her in her choice of healthy food?…. if you see an obese child, you see an obese parent….
If you have a fat kid, don’t make a big deal out of it, and be sure to check any shame or embarrassment at the door. And for God’s sake, don’t obsess about your own weight in front of the kid. Love the kid; celebrate their interests; don’t manipulate them into doing ‘activities’. Just listen and love. The minute you start manipulating or doing anything passive aggressive, you’ve pretty much doomed your kid. Good luck.
— Formerly FatSomeone should try to honestly figure out why children are more obese than they used to be. Is it really that they spend so much time at the computer playing video games? Kids of my generation spent alot of time in front of the TV; we didn’t get that fat. Is it that kids eat too much junk food? We ate alot of hot dogs and hamburgers when we were kids; we didn’t get that fat.
How many of these kids have parents that are so fat phobic that they load the kids up with carbohydrates? We used to have steak and pork for dinner every night and sometimes chicken. We weren’t fat. Why? Because we weren’t hungry all the time. Maybe, just maybe it’s all the nutritionists and doctors who have been pontificating about what diet is healthy for the last 25 years who are responsible for our kids being so fat. Maybe it’s all been a lie.
— WigWagI think it would be impossible to figure out EXACTLY why children are more obese than they used to be, as it is extremely multifactoral. And yes, the nutrition industry has had its faults, but can you really justify that advocating consumption of healthy foods and avoidance of junk foods etc. has caused the obesity epidemic in children? Make healthier choices, move a little bit more, and promote a happy, unstressful eating environment for your children. I doubt anyone would be able to argue that those things “have all been lies.”
— casNYCTherese is right on. While a case may be made for various environmental impacts on childhood obesity, at the end of the day it comes down food intake and caloric burn.
And parents have to take the lead.
To the right of this post, there are images of a wall of bell peppers and Jack LaLanne doing some incredibly difficult push-ups.
There are your models.
Fruit,veg,healthy oil & lean protein - for everybody - mam and dad included
No t.v., video games & computer for schoolwork only
Get active with your kids - go for a walk every night. go swimming - play tennis - something
If the parents want to see a change in their children, isn’t it hypocritical not to live that change as well?
— DRTalk to your gov’t representative about public outdoor fitness - see here - http://healthhabits.wordpress.com/2008/04/15/fitness-alfresco/
Thinking outside the box
— DRI feel sorry for that little girl in the photograph. It’s gonna suck growing up, fat or thin, and telling her kids, fat or thin, “I was in The Times once. For being fat.”
FROM TPP — She’s not identifiable. But I agree it’s a sad picture.
— Brennon SlatteryIt is, indeed, simple math. The Times ran an article about 10 days ago on how active Swiss people are. The author, after hiking 5 hours above the tree line, decided she could go no further and made camp. She was shortly passed by a family of 6, I recall, including twin 4 year olds, a 7 year old, and a 9 yr. old who still had about 2 more hours to go until they reached their destination. There’s your answer to youth (and adult) obesity.
http://swine.wordpress.com
— Alex M. PruteanuThe advise to parents to replace whole milk with 1% or skim milk is one of the lesser known factors in pediatric obesity.
According to the findings of a survey of 12,000 children between 9 and 14 years of age, conducted by Harvard University researchers and published in the Journal Archives of Pediatrics & Adolescent Medicine in June of 2005, that isn’t the case:
“Contrary to our hypotheses, dietary calcium and skim and 1% milk were associated with weight gain, but dairy fat was not.” [1]
In addition to accelerating weight gain, skim milk may increase the incidence of autism and diabetes, and subvert the sole rational behind milk consumption, which is to prevent bone diseases, poor immunity, eyesight loss, and metabolic disorders related to the deficiency of vitamin D.
There are two reasons behind this “phenomenon”:
— First, a glass of whole milk contains 8 g of fat and 13 g of lactose, or a total of 124 calories. A glass of 1% and skim milk contains, respectively, 79 and 53 calories. Considering the taste of skim milk, children are more likely to consume 1% milk. The net reduction of energy content between a glass of 3.5% whole and 1% milk is a paltry 45 calories—an insignificant reduction in the interests of preventing obesity (2).
— Secondly, even though each gram of fat provides 9 calories of energy, this value only applies to fat already stored in the body. The net energy value of fat from food sources is considerably less, because dietary fat requires a certain amount of energy to get digested, assimilated, stored, and converted to usable energy in the first place. Besides, most of the saturated fat—the dominant kind found in a glass or two of whole milk—doesn’t become body fat, but is used to synthesize vital substances, such as cellular components, hormones, vitamins, and many others.
Reducing the fat content of milk impacts children’s health even more negatively than their weight. To begin with, there is nothing natural about skim or reduced-fat milk. It is fortified [3] with synthetic vitamins A (retinyl palmitate) and vitamin D3 (7-dehydro-cholesterol), because natural vitamin A is lost during the removal of fat, while milk is naturally low in vitamin D. Some dairy products are also fortified with calcium because natural calcium is bound by milk proteins, and digests poorly.
The fortification of dairy with vitamin A is mandated by the federal government in order to prevent blindness and poor immunity in children. Vitamin D and calcium are added to protect children from rickets and scoliosis—a softening of the skeletal bones. A vitamin D deficiency is also implicated in type 1 diabetes [4], which predominantly affects children.
Ironically, the fat-soluble vitamins A and D, and the calcium in skim and reduced fat milk are almost useless, because they all require the presence of dietary fat in order to get digested. Adding insult to injury, widespread allergies to casein (milk protein) and lactose intolerance causes intestinal inflammation — one of the primary causes of malnutrition-related autism, — and renders vitamin A, D, calcium, and other milk nutrients futile.
In essence skimming the fat from milk is yet another case of good intentions gone bad. Who benefits from all this? The milk industry, of course: the milk fat is sold as butter and cream, while the whey (cheap livestock feed not so long ago), is resold at fat profits as skim or reconstituted 1% milk.
In no way do I wish to imply that diary products are bad. They are indeed a good source of vital nutrients for children of all ages as long as they’re consumed in their natural, unadulterated form. Cheeses and fermented diary products such as whole milk yogurt or kefir are best, because the bacterial fermentation eliminates most of the lactose and breaks down the bonds between milk protein and calcium.
If you prefer not to give milk to your child, liquid cod liver oil (not capsules) is the best source for vitamins A and D, and equally vital Omega-3 fatty acids. It’s especially beneficial during the winter months, when there isn’t enough sun exposure to synthesize intrinsic vitamin D, and diets are lacking in naturally-ripened produce, which is rich in beta-carotene (a precursor to vitamin A).
And don’t get vexed over the taste of cod liver oil: a mint- and lemon-flavored varieties that are sold today are palatable even to a discriminating two year old.
Konstantin Monastyrsky, author of Fiber Menace
P.S. I realize this post may steer some controversy. So I posted all references (1 through 4) at http://www.FiberMenace.com. Before questioning my sanity, please review them. The sources are the National Institutes of Health, the United States Department of Agriculture, and the National Dairy Council.
— Konstantin MonastyrskyI read all these generalities and try to relate them to the parents and kids I see around me. What I see are too many fat-phobes whose kids are pudgy and undernourished. They need eggs and bacon and whole milk and they get soy, or worse, junk food.
— HattieSome friends of ours were over at our place recently with their boy, and their father actually asked me, “Do you think we should limit his food intake? He eats a lot.” What I notice about them is that food isn’t readily available in their house, so whenever the boy gets a chance to eat, he eats everything in sight. So I said, “Do you want him to be short?” That’s what I see these days: short, fat people. And this is where it starts. Food deprived in childhood, short and obese in adulthood. And of course the minute girls start developing they go on diets and actually get praised in some families for not eating. What’s that about?
The girl IS identifiable to some people. Her family, her friends, school personnel. A very poor choice for a photo.
— JazWhile growing up, I was constantly told I was fat, from like age 5 on. Even before my high school graduation, I was told I was fat. Then, several years later, after a stint in the Navy, (where, at one point, I was down to 139 pounds) I was looking at the pictures of my high school graduation. I kept looking for the fat kid. I never found him. I confronted my mother about this, and she just shrugged and said, “So?”
— ScotI am now, some 20 years later, obese. I am in the process now of losing weight through diet and exercise. It is not easy. A good chunk of the responsibility for this is my own fault, but some of it lies with my parents also.
In addition to providing children with opportunities for healthy diet and exercise, it is also the parents’ responsibility to provide a positive body image and self-esteem as well. That is just as important.
Therese (#1) - you really think the woman on the right in the photo is overweight? She’s no stick figure, but, really…..overweight?? She looks to be in a perfectly acceptable weight range to me. I think the current belief that ultra-thin is somehow the only “healthy” weight is just as screwed up as the rising rates of obesity. When I was growing up, a size 12 was not a “plus size,” as the magazines and TV (America’s Next Top Model, for ex.) are touting it now. It’s also very unfortunate, TPP, that you felt the need to say a photo of a little girl having her hands held lovingly by two adults is “sad.” Yes, her weight is unfortunate and unhealthy, but you don’t know anything else about this little girl, so please refrain from judgments. I know it’s shocking to believe, but an overweight child can still be happy and loved!
FROM TPP — I don’t think I was being judgmental. The reality is that kids who are overweight are often teased and ostracized. The fact that this little girl is at this event for overweight children means that her family cares for her and is concerned about her health. It also means they recognize her weight has become a problem for her.
— Cathy W.Therese at #1: It ain’t necessarily so. Neither of my parents were overweight when I was growing up - in fact my mother was fashionably stick-skinny. Both later put on weight. I was a chubby child, pushed into obesity in adolescence by the bullying of the slim kids, and finally into anorexia by high school (so you see, I’ve run the gamut). Formerly Fat at #2 is spot on. I would add, nobody is totally sedentary - there’s got to be some physical activity that is fun. I was clumsy (and bookish w/glassses - three strikes, you’re out!) so team and competitive sports were a humiliating, hellish ordeal. (A sure recipe for obesity, when the only friend you can trust not to mock you is “Little Debbie.”) Steer the kids to activities such as swimming, horseback riding, golf, bowling - activities that don’t necessarily involve a team or scorekeeping (though they could). Golden Rule of Exercise: “If it isn’t fun, it isn’t done.”
— ACWHasn’t anyone noticed all the pictures of the earthquake in China and how you don’t see any fat kids or parents? Contrast that to the scenes we saw from Katrina. We’ve created a national culture of inactivity, junk food, and parents modeling the wrong behavior.
— WLI think eating habits have changed since I was a child in the 1970s. Children eat a lot more of the type of foods characterized as “high GI” or high on the glycemic index (over 35 or 40). This includes all types of sodas and sweetened drinks, juice, all refined carbohydrates such as white bread and white rice, and fried potatoes. (Not to mention partially hydrogenated oil is everywhere.)
Plus they eat out a lot more. We went out maybe twice a year when I was a child.
I don’t think the answer for kids is to put them on a diet. Just make sure they eat normal meals and snacks. “Normal” means plenty of non-starchy vegetables, beans, whole grains, fat, and protein. And cut out the soda.
Let them have one serving of junk food (white bread, french fries, potato chips, candy, and cookies) a day, not four or five at every meal, which seems to have become the new norm.
If you have the time and talent to cook from scratch at home, so much the better.
— moparRe post #1: You are correct that children are not responsible for the food adults give them to eat. However, please re-think your impression of the picture. The adult on the child’s right is NOT overweight. Pictures can be deceiving.
— KTI have been concerned about children’s health because of all the empty calorie foods that are being advertised to kids and the fact that recess time has been shortened in many schools. Parents can work with schools to improve school recess time and kid’s lunches- or we can pack nutritious lunch bags and make sure kids have time to play outside after school or even have family ‘fun sports’ time a few times a week.
Another neat online tool I found is: http://www.nourishinteractive.com is great website for kids has free nutrition games such as: The Chef Solus Food Pyramid Adventure, flash games, puzzles and activities all use fun characters to teach kids to choose healthy foods and encourage them to get 60 minutes a day of exercise. The animated characters teach these lessons and it seems to work much better than when adults try to encourage kids to eat better! My niece is allowed to play 15 minutes a day of online games, she played the demo of this game and loved it, so I signed up for a free membership and now I also get a parents’ nutrition tips newsletter with information and activities to try at home. I shared the tips with my sister and we are all working to help my niece with her weight issue.
It was fun and interactive and that night she was even telling me I should have more vegetables on my plate and suggested a family game of frisbee after dinner to get exercise. This was great as she never usually initiates active games!
— Kristina LeeHas anyone looked at the link between stress and obese children? I’m an advocate for a child in the foster care system who, at 9 years old and under 5 ft tall, weighs 190 lbs. She really eats when her stress level is high. She has no sense of satiety and will eat as long as food is in front of her. When things are going better she eats more normal size portions and says she is full. Anorexia is psychological and behavioral, why not overeating? Maybe combined with over sized portions and easy, frequent access to high calorie foods, stress is another part of the equation.
— MGIt’s simply not that difficult to stay healthy nor to pass on healthful (or at the very least, non-destructive) attitudes to your children. Why are children obese? Because their parents simply do not impart to them the tools necessary to be anything but.
One can only assume this is a cultural problem passed down from generation to generation, sloth begetting sloth. It has become time to turn our backs to those who won’t help themselves. Let them drive their SUVs til they’re broke, let them deaden their brains in front of the boob-tube, let them fritter away their incomes on baubles at the mall.
— ClotarioLet us - those who know better - do something else.
To really deal with childhood obesity requires othing short of a major sea change in American economic policy to restore the buying power of earnings so mothers can choose to be fulltime homemakers. Without regular home cooked meals and effective supervision of snacking children pig out on junk food. Absent mothers toiling away long hours at work to make family ends meet leave the children emotionally and attention starved further stimulating the need to overeat.
Beats me why all this so hard for people to understand.
— MARK KLEIN, M.D.I remember hours outside with my parents, even if it was something as simple as gardening together. We need to get children away from the television, away from video games, etc., and get them outside to play. Parents need to do the same. Take your children for a walk, toss a frisbee in the backyard. Do something!
— barbaraParents also need to provide healthy food; however, I can understand some parents buying less nutritional food at the stores as food prices soar many families cannot afford fresh fruits and vegetables, cannot afford the leaner meats. However, if they stay away from “fast” food, it will help tremendously.
It won’t be easy giving up old habits, but you can do it.
Stop buying soda! And milk is not a healty alternative if it’s full of sugar and artificial flavors.
— LeslieHere’s some food for thought from a “grown-up fat kid” who was a precursor to the “obesity epidemic” (I was born in ‘78, so you do the math).
I was a fat kid (and now I’m a fat adult), as was my sister, and both of our parents were thin.
My size 6 mother constantly obsessed about our food intake (which was strictly limited). We weren’t allowed to have sugar. She cried at our doctor’s appointments when our idiot pediatrician blamed her for us being overweight.
I was the only kid in my class who pulled carrot and celery sticks out of my lunch box instead of a devil dog. I was teased relentlessly.
I was sent to birthday parties with a note from my mother, asking the parent of the birthday boy/girl not to let me have more than a quarter of a slice of cake (i.e. 3 child size bites). I got teased for that, too.
Everything in our house was “diet” or “lowfat”. We were only allowed sugarless gum or diet soda sparingly, and the only cereal we were allowed to eat was Cheerios. I never had “regular” kids cereal or regular soda until I went to college (and I didn’t like either of them, because they were too sweet).
While mom was handling the food issues, my dad was the drill sergeant who signed us up for every physical activity known to man (soccer, little league, basketball, etc.) hoping that we would finally be the thin, normal children he wanted. While I became an excellent softball player, I was still fat. That wasn’t good enough for him.
In a nutshell, I spent the first 25 of my 30 years feeling like a worthless failure due to my inability to be thin, no matter how little I ate or which diet I tried. 5 years ago, I made a conscious decision to start living my life as if there were more to it than just being fat or thin. I’ve never been so happy, even though I’m considered “obese”. Thanks to being physically active, I also have perfect blood pressure, cholesterol, and am not a type II diabetic.
So while it would be lovely and easy for us to apply an 1+1=2 logic here, we really can’t. Every situation is different. And as for “feeling sorry” for the little girl in the picture, I don’t think she needs our pity. Instead of seeing “just a little fat kid” like many of you seem to, I see a kid who’s obviously got two people who love her enough to hold her hands and walk with her somewhere. Maybe it would have been more apropos for this article had she been sitting in front of a tv stuffing her face? Then we could all go ahead and “feel sorry.”
— TaraTimes have changed. Kids don’t walk to school anymore, they get driven in SUV’s. They don’t play outside anymore after school. Part of it is parent anxiety about abductions. And, if your’s the only kids walk to school, they may not be safe. My kids, now in their 30’s, walked to school in a pack with the neighbor kids. They all played soccer on the weekends in elementary school and for the school teams when they were in junior and senior high school. As their parents we set a good example, walking into town rather than taking the car, riding our bikes or jogging for exercise, serving healthy meals (meat, chicken, fish, vegetable and starch). My four offspring are slim to this day. And, it’s not just heredity because two are adopted. We limited television time to an hour a day and computer games were in their infancy (remember pacman?). Today’s kids are growing up in a different atmosphere.
— Barbara A. Rall