Obese Children

Obesity can be broadly defined as too much body fat. Levels of obesity may be measured by a body mass index scale known as the BMI index. BMI projects obesity by assessing body proportions and fat deposits based on a height and weight scale. Obesity is a huge problem in the United States, and is considered to be a threatening epidemic. This is the case especially for our youth population who are vulnerable to many future obesity risks that are somewhat beyond their control. Children do not manage what they eat, drink, or what is prepared for them in school. In addition, children have lost many of the opportunities to "play" outside as society promotes a culture of computer games, video games, and television. If statistics report that "approximately 30.3 percent of children (ages 6 to 11) are overweight and 15.3 percent are obese," and that, "for adolescents (ages 12 to 19), 30.4 percent are overweight and 15.5 percent are obese," then who is to blame (http://www.obesity.org/subs/fastfacts/obesity_youth.shtml)? The answer to this is not simple primarily because there are many causes of the growing levels of obesity in children. Family income, contemporary eating habits and standards, and a growing avoidance of exercise all contribute to the rising levels of obesity in children. Family income is an important factor when considering obesity causes in children. In this country fast food is relatively cheaper than a quality meal. A McDonald's double cheeseburger costs one dollar. The problem with this is that the burger alone has a whopping 480 calories and 23 grams of fat (http://app.mcdonalds.com/bagamcmeal?process=item&itemID=10009). To counter this, some people support how cheap and accessible fast food is. Even though I acknowledge that it is convenient and that McDonald's is trying to offer healthier selections, the average kid that I know gets a happy meal, ignorant of its nutritional value, or the lack of it. The healthier alternative could be a grilled chicken caesar salad that has only 220 calories and six grams of fat. Unfortunately, this alternative cost five times more than the double cheeseburger (http://app.mcdonalds.com/bagamcmeal?process=item&itemID=10068). Income varies from household to household, so the cost of healthy food is an important factor to the health of children. If they can afford better quality meals, families with higher incomes may be physically fit and able to eat lean healthy diets. In contrast, families with lower incomes who cannot afford to buy more expensive, yet healthier alternatives may be not as physically fit due to their inferior diet. In this country the lowest incomes can be associated with disadvantaged minorities. Subsequently, the highest rates of obesity are also linked with poor minorities (http://www.obesity.org/subs/fastfacts/Obesity_Minority_Pop.shtml). This leaves a distinct group of children vulnerable to obesity that can be linked to poor diets. The graph below summarizes that over time, the population has gotten more overweight and obese. It also shows the disproportionate numbers of obese minorities relative to Whites.

Increase in Overweight and Obesity Prevalence

Among U.S. Adults* by Racial / Ethnic Group

Overweight

(BMI > 25)

Prevalence (%) Obesity

(BMI > 30)

Prevalence (%)

Racial / Ethnic Group 1988 to 1994 1999 to 2000 1988 to 1994 1999 to 2000

Black (non-Hispanic) 62.5 69.6 30.2 39.9

Mexican American 67.4 73.4 28.4 34.4

White (non-Hispanic) 52.6 62.3 21.2 28.7

Fig. 1. Source: CDC, National Center for Health Statistics, National Health and Nutrition Examination Survey. Flegal et. al. JAMA. 2002; 288:1723-7 and IJO. 1998;22:39-47. *Ages 20 and older for 1999 to 2000 and ages 20 to 74 for 1988 to 1994.

In hindsight, I understand that my family was a statistic. I lived in a lower income home. We could not afford high quality meals. Also, we all were slightly overweight. For example, my eleven year old brother weighs 160 pounds at five feet tall. His BMI is over 31 percent which means that he is obese (http://www.healthyhearts4kids.org/intro/parent/BMI.asp). My parents bought value meals from McDonald's, boxes of Popeye's chicken and other unhealthy but conveniently cheap fast food. Even today, those old habits have not changed, since I tend to purchase fast food quite often instead of the more expensive healthier food choices. National surveys support my personal story. "The National Longitudinal Survey of Youth for four- to twelve-year-olds indicates that low-income children have higher obesity rates than do wealthier children" (http://www.futureofchildren.org/information2827/information_show.htm?doc_id=355759). Does this mean that low income children are destined to be fat? Even at school, kids may not be able to control their eating habits or what they eat. Standards for nutrition in school have relaxed over the years. Last month, a Massachusetts