From Table to Grave: Childhood Obesity

Many diseases plague our nation today: cardiovascular disease, cancer, high blood pressure, and diabetes, which in itself can lead to blindness, neuropathy (nerve damage), and kidney failure. These diseases have invaded the lives of people for many years. People who have been diagnosed with these diseases have undergone extensive treatment, painful surgeries, and many have died. In the past, we have associated these diseases with adults. But today, these diseases are being found in children.

The increase of diseases in children is linked to childhood obesity. Over the past years, childhood obesity has grown tremendously in the United States. "According to the latest federal figures, the percentage of youngsters age six to eleven who are overweight has tripled since the 1960s. As many as one in five kids is overweight or obese" (Ellin XXXVI). Obesity in children is "now an epidemic in the United States" (Torgan 1). This epidemic is not limited to a particular age group or race, though it is more predominant in African-Americans; it's occurring in youth and adolescents in every race, in both boys and girls. Without proper treatment, children are more likely to become obese adults and develop major health problems.

Obesity is defined as an excessive accumulation of body fat. Obesity is present when total body weight is more than 25 percent fat in boys and more than 32 percent fat in girls (Lohman 98-99). Although childhood obesity is often defined as a weight-for-

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height in excess of 120 percent of the ideal, skin fold measures are more accurate determinants of fatness (Dietz 676-686; Lohman 100-102). Skin fold thickness is a

technique used to assess body composition by measuring a double thickness of skin at specific body sites. The triceps alone, triceps and subscapular (just beneath the shoulder blade), triceps and calf, and calf alone have been used with children and adolescents. When the triceps and calf are used, a sum of skin folds of 10-25mm is considered optimal for boys, and 16-30mm is optimal for girls (Lohman 101).

According to Torgan, "The number of children who are overweight has doubled in the last two to three decades" (2). Several factors have contributed to the rising numbers of obese children. Lack of physical activity is the leading cause of obesity in children. Children have decreased their involvement in physical activities, and have increased their involvement in sedentary activities. Time that was once used for exercising and playing sports is now being used to watch television, surf the internet, or play video games. For example, several studies by Dietz have found that increased television viewing increases the percentage of time children spend on sedentary activities. Without a corresponding reduction in caloric intake, obesity may result ("Television" 543-550). Many health care professionals prescribe impact type exercises for obese children; however, these children often suffer from joint pain or discomfort because of their excess weight, and often do not follow this advice.

Poor eating habits and the environment has also contributed to overweight children. Children are now consuming more foods that are high in calories. They are more inclined to eating when not hungry, eating while watching television, and/or eating

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while doing homework. Eating well-balanced, home-cooked meals together as a family has become almost obsolete. Instead, they rely on fast food that is cheap and convenient. In an attempt to increase earnings, fast food franchises advertise appealing and tasteful foods that are high in calories. Additionally, we as consumers are more inclined to "super-size" or "king-size" a value meal order because it may be a better value for the money. But by doing this, we add more calories to a meal that is already high in calories.

Although most causes of obesity in children are modifiable, some are not. Genetics is a non-changeable cause of obesity. Greater risk of obesity has been found in children of obese and overweight parents. Since not all children who eat non-nutritious foods, watch several hours of television daily, and are relatively inactive develop obesity, the search continues for alternative causes. Heredity has recently been shown to influence fatness, regional fat distribution, and response to overfeeding (Bouchard, et al. 1477-1482). In addition, infants born to overweight mothers have been found to gain more weight and be less active by age three months when compared with infants of normal weight mothers. This suggests a possible inborn drive to conserve energy. According to Lohman, not all obese infants become obese children, and not all obese children become obese adults. However, the prevalence of obesity increases with age among both males and females (98-102). There is also a greater likelihood that obesity beginning even in early childhood will persist through the life span (Epstein, Wing, Koeske, and Valoski 91-95).

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Obesity presents numerous problems for the child. In addition to increasing the risk of obesity in adulthood, childhood obesity is the leading cause of pediatric hypertension, and is associated with Type II diabetes. The risk of coronary heart disease and stress on the weight-bearing joints is also increased in obese children. Obese

children have a high incidence of orthopedic problems, liver disease, and asthma. Sleep apnea, interrupted breathing while sleeping, is one of the most severe problems for obese children. Sleep apnea can lead to problems with learning and memory. Obesity lowers children's self-esteem, and affects relationships with peers. Some authorities feel that social and psychological problems are the most significant consequences of obesity in children.

When treating obesity in children, it is vital that parents and physicians are not aggressive. Yet, they must be sensitive to their needs and concentrate on the main goal. Small, achievable weight loss goals should be set to avoid discouragement and to allow for the normal growth process. According to the American Obesity Association

involvement of the entire family is also a motivating factor. Weight control programs that involve both parents and the child have shown improvement in long-term effectiveness compared to gearing the program only to the child.

There are several treatments that can be used when trying to control or prevent obesity in children. The first method to control obesity is dietary therapy. Studies show that as children get older, their diet quality declines. Parents should consult a dietitian or nutritionist that is specialized in childhood