Childhood obesity rates aren’t improving, according to a recent study in the journal Pediatrics.
In fact, obesity rates for preschoolers jumped dramatically, from 14 percent in 1999 to 18.5 percent in 2015 and 2016.
This may seem surprising after years of efforts to make school lunches healthier and a national push to encourage daily exercise.
What are we, as a nation, doing wrong?
We turn to Kelly Layton, a dietitian and nutritionist for Lehigh Valley Health Network with our questions about childhood obesity and what we can do to help our kids be healthier:
Q: For children, what’s considered a healthy body mass index? When should I be concerned?
A: We assess a healthy body mass index or BMI differently for children. For adults, a BMI of 25-30 is overweight and greater than 30 is obese. We classify pediatric obesity using Centers for Disease Control and Prevention growth charts. A BMI between the 85th-95th percentile for a child’s age is considered overweight, and greater than 95th percentile is considered obese.
If you are concerned about your child’s weight, the focus should be weight trends over time. Their growth generally should follow the curve of the chart. Also, a significant gain in weight without a corresponding change in height may be notable as well. If your child’s BMI is around the 85th percentile and climbs sharply to a higher percentile as they grow, it may be time to consult a physician or registered dietitian.
Q: We all know generally that obesity means that a person has too much body fat. But what is the overall effect of being obese?
A: The main issue is that obese adolescents have a greater risk of developing chronic diseases like type 2 diabetes or heart disease earlier and later in life. These diseases are largely preventable with proper nutrition and exercise. Obesity also increases the likelihood of developing depression, body-image issues and facing discrimination or bullying at school.
Q: The study shows that obesity rates have stayed stable or increased in some age groups. What do you attribute this to?
A: I attribute this to how little nutrition education parents and children get in our country and a food environment that does not prioritize health.
Nutrition education should target parents first, as they are the largest influence on their children’s eating habits in the early years.
We also have poor budgets at school when it comes to nutrition initiatives. School cafeterias must work with tight budgets. And even with healthy cafeteria options, kids won’t pick them if they haven’t been exposed to healthy options at home, don’t know how to select a healthy plate, or haven’t been taught the benefits of nutritious eating.
Low-income and minority populations are also most susceptible to environmental causes of obesity and have the highest childhood obesity rates. Many families live in what we call “food deserts,” where they do not have access to a regular grocery store with fresh produce close by. Instead foods are mostly purchased at convenience stores and fast food chains, where tasty food is cheap, high in calories, highly processed and lacks healthy nutrients.
Q: When we think of obesity we think of food but how much of a factor is exercise?
A: Both food and exercise influence weight, but typically food plays a greater role. For example, you can cut 500 calories a day (enough to lose one pound a week) by skipping one candy bar and one bottle of soda a day. In contrast, you’d have to jog for 45 minutes straight or walk briskly for an hour and a half to burn that many calories.
However, exercise affects weight as well and is healthy for other reasons other than weight management. Not only does exercise burn calories, it also keeps kids away from grazing on junk foods when they sit on the couch. Getting your child involved on a sports team might be easier and more enjoyable than dragging kids to a gym, and they may burn more calories that way, too, especially in higher-intensity sports like track, basketball, tennis and swimming. If school sports aren’t for them, they might enjoy activities like dance classes, martial arts, or camping and hiking.
Q: If my child has an unhealthy BMI, what measures should I take? Should I put my child on a diet?
A: Except for cases of extreme obesity (greater than 99th percentile), encouraging weight loss in children is not recommended under age 12. Rather, we want their weight to stay the same and essentially have them “catch up to it” as they get taller.
The first step is to assess your home food environment. First, work on finding healthy options from all food groups that your kids enjoy, which may require exposing them to healthy foods many different times and prepared in many different ways. Aim to have only a few junk foods in your house and make them less visible, storing them up high and behind closed doors.
I advise caution in putting your child on a diet. Formal weight loss interventions are more appropriate for teens than children, but should still be approached with the help of a professional. Use the growth charts and ask a doctor or registered dietitian to understand how much of a risk your child is at with their weight. Interventions are very different for children with just a few extra pounds versus extreme morbid obesity.
Q: We have heard parents of obese children say “he needs to grow” or “it’s just baby fat.” Why is maintaining a healthy weight important throughout a child’s life?
A: Maintaining a healthy weight helps prevent chronic disease and serves as one predictor of both current and future health. All children have growth spurts, but kids generally follow the shape of the curve on the growth chart during normal growth. Also, expecting weight to level off (especially when they’re near that 85th percentile) should not be used as an excuse to turn a blind eye to unhealthy habits at home. Being overweight at a younger age should be an indicator for parents to re-evaluate their child’s environment and routine, and then find ways to promote more physical activity and exposure to healthier foods.
Q: How do parents encourage healthy body images for children? What’s the best way to encourage a healthy body weight while fostering a healthy self-image?
A: The main focus with kids should be on building long-term healthy habits first. Weight should be discussed as one factor related to their health, but never as the one and only focus. Also, a very important way to promote a good self-image is to be a role model for your kids. They need to see that taking care of one’s health can be enjoyable, satisfying and self-empowering.
By Jenniffer Mcall
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