Editor’s Note: We’ve gone on a search-and-rescue mission to find amazing stories and essays published in earlier print editions of Rootstock. Today’s throwback, “Childhood Obesity 101: A Parent’s Primer for Prevention,” was written by Melinda Hemmelgarn, M.S., R.D. for the Fall 2009 edition of Rootstock.
Take one look at the chart above and you’d swear someone put something in our water. Back in the 1970s kids started gaining weight, and despite our best efforts to reverse the trend, children’s obesity rates have tripled over the past few decades. Rates are highest among minority children and those living in poverty. Worse, the current economic downturn threatens to further fuel the upward trend as consumers seek out “value meals.” 1
Sadly, even though there are more overweight children today than when we were kids, the teasing and bullying associated with being “different” hasn’t subsided. In fact, overweight children surveyed rated their quality of life as low as children receiving chemotherapy for cancer treatment. 2
Overweight kids suffer from lower self-esteem and poor body image which may lead them down the dangerous path of unsafe diet pills or overly restrictive diets. Adding insult to injury, being overweight makes it more diffi cult for children to enjoy physical play and participate in sports. They may be rejected from teams, feel embarrassed in a swimsuit, or awkward in gym class.
Obesity also puts kids at greater risk for heart disease and Type 2 Diabetes, a disease previously seen in adults. According to the Centers for Disease Control and Prevention, if current trends continue, one in three children born in 2000 and beyond will develop diabetes in their lifetime. If the child is Black or Hispanic, the number jumps to one in two. Our Native American children also carry a larger burden of obesity and related illness. 3,4
What’s going on?
Let’s take another look at the trends graph and pinpoint key events leading to the fattening our children:
1. High Fructose Corn Syrup (HFCS). According to USDA, the cheap corn sweetener didn’t enter our food system until 1974, when it started replacing more costly cane and beet sugars. Today, most sodas and popular kids’ fruit drinks are sweetened with HFCS. While we can’t blame the sweetener entirely for the obesity epidemic, it certainly contributed to the problem because of its abundance in our food supply. Dr. Robert Lustig, a pediatric endocrinologist at the University of California-San Francisco, says “the problem is the quantity consumed.” 5
2. Fast food. McDonald’s rolled out their Happy Meals® in 19796 and fueled the rise in fast food consumption over the decades that followed.7 Key to the kid’s meal success is the limited-time-offered toy, which adds a sense of urgency to its appeal. The high-calorie, low-fiber meals favor the development of insulin resistance and related obesity.8 We know that truly “happy” meals are organic, but according to a McDonald’s spokesperson, “There are no plans to incorporate organic foods into our menu.” 9
3. Advertising directed towards children. In 1978, the Federal Trade Commission proposed a ban on advertising to children under eight years of age because young children can’t understand persuasive language. Advertisers worried that they’d lose access to the lucrative child market, so they convinced Congress to pass the “FTC Improvement Act” in 1980. Hardly an “improvement” for our kids, the Act cut the FTC’s power to regulate advertising to children. The Campaign for a Commercial Free Childhood reports: “since then, child-directed marketing has escalated exponentially with virtually no government oversight.”10 We’ve since learned that advertising infl uences children’s food preferences and requests. And, the majority of food advertised to children is of poor nutritional quality. 11, 12 Have you seen any commercials on Saturday morning TV for organic milk and vegetables? I didn’t think so.
4. Super sizes. Portion sizes of cheap fatty and sugary foods began to grow in the 1970s. Portion sizes continued to rise sharply in the 1980s, and have continued to increase right along with body weight. Children and adults consume more when we’re served more. 13
5. Endocrine disruptors. Changes in diet and exercise alone can’t fully explain the dramatic increase in the incidence of obesity that we’ve seen over the past two decades. Some researchers have noticed a parallel increase in obesity with our dramatic rise in the use of plastics.14 Endocrine disrupting compounds from both plastics and pesticides can cause insulin resistance, weight gain, and even damage our genes, depending on when we’re exposed. 1,15
What’s a Parent to Do?
As gatekeepers for our family’s food and health, we can have tremendous influence. Here’s the best advice to date on how to keep our children healthy and fit:
1. Plan ahead. When you’re travelling, pack a cooler. Hiking? Bring a backpack with organic cheese and fruit. Busy week? Plan to reheat leftovers. Going out for fast food is not a treat. It’s a prescription for obesity. Just say NO.
2. Skip sweetened drinks. Instead, choose organic milk, water, or 100% organic fruit juice diluted with plain water.
3. Shrink portion sizes. Use smaller plates and bowls, and let children serve themselves – they tend to take less than when an adult does the dishing. A good rule of thumb is one Tablespoon per year of life for children younger than six. 16
4. Tame the TV. The American Academy of Pediatrics advises no more than 2 hours of quality screen time per day, and no TV or videos for children less than two.17 The AAP also recommends removing TVs from children’s bedrooms. Sage advice: Trade screen time for “green” time.
5. Ensure adequate sleep. Lack of sleep plays havoc with hormones that regulate blood sugar and appetite, leading to weight gain. 18
6. Teach children how to garden, cook and preserve fresh food from your own organic garden. They’ll develop a taste for the good stuff!
7. Be compassionate. Help overweight children feel good about themselves, regardless of their shape or size. Make your home a safe haven from ridicule.
8. Advocate for and with your kids. Work together with fellow parents and students to change school food policies to get junk out and farm fresh, safe organic foods in. 19
1. F as in Fat: How Obesity Policies Are Failing in America 2009, Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation. http://healthyamericans.org/reports/obesity2009/
2. Schwimmer, J. et al. “Health-Related Quality of Life of Severely Obese Children and Adolescents,” JAMA, Apr 2003;289:1813-1819.
3. Dept. of Health and Human Services: http://wayback.archive-it.org/3926/20130930183857/http://archive.hhs.gov/news/press/2004pres/20040429.html
4. American Diabetes Association: http://www.diabetes.org/diabetes-basics/statistics/
5. Personal communication with Dr. Robert Lustig, July 16, 2008. http://chc.ucsf.edu/coast/faculty_lustig.html
6. “Decades of Memorable Happy Meals.” http://mcdepk.com/happybirthdayhappymeal/downloads/memorable_happy_meals.pdf
7. Pereira, M. et al. “Fast Food Habits, Weight Gain, and Insulin Resistance: 15-Year Prospective Analysis,” The Lancet. 2005; 365(9453):36-42.
8. Isganaitis, E and Lustig, R.H., “Fast Food, Central Nervous System Insulin Resistance, and Obesity,”, Arteriosclerosis, Thrombosis, and Vascular Biology. 2005; 25:2451 http://atvb.ahajournals.org/cgi/content/full/atvbaha;25/12/2451
9. Personal communication with Julie Pottebaum, McDonald’s USA, U.S. Media Relations, 7/30/09.
10. Campaign for a Commercial Free Childhood. www.commercialexploitation.org/
11. Institute of Medicine. “Food Marketing to Children and Youth: Threat or Opportunity,” December 2005. http://www.iom.edu/reports/2005/food-marketing-to-children-and-youth-threat-or-opportunity.aspx
12. Federal Trade Commission. “Marketing Food to Children and Adolescents: A Review of Industry Expenditures, Activities and Self-Regulation: A Report to Congress. http://www.ftc.gov/reports/marketing-food-children-adolescents-review-industry-expenditures-activities-self-regulation
13. Young, L.R., and Nestle, M. “The Contribution of Expanding Portion Sizes to the US Obesity Epidemic,” Am J Public Health 2002; 92:246-9.
14. VomSaal, F., et. al. “Environmental Estrogens, Endocrine Disruptors and Obesity,” in: Obesity: Epidemiology, Pathophysiology, and Prevention, Bagchi,D. and Preuss, H., editors. CRC Press, 2007
15. McCullum-Gomez, C., Benbrook, C., and Theur, R., “Endocrine Disruptors, Pesticides and Other Environmental Toxins,” in: That First Step: Organic Food and a Healthier Future. March, 2009.
16. USDA/ARS Children’s Nutrition Research Center. www.bcm.edu/cnrc/
17. “Children, Adolescents and Television,” AAP Policy Statement. http://pediatrics.aappublications.org/content/107/2/423.full
18. Gangwisch JE, et. al. “Inadequate sleep as a risk factor for obesity: analyses of the NHANES I.,” SLEEP 2005;28(10): 1289-1296.
19. “10 Tips for Child Advocates,” American Academy of Pediatrics. http://www.aap.org/en-us/advocacy-and-policy/state-advocacy/Pages/Ten-Tips-for-Child-Advocates.aspx
20. USDA. “Adoption of Genetically Modified Crops in the U.S.” http://www.ers.usda.gov/data-products/adoption-of-genetically-engineered-crops-in-the-us/recent-trends-in-ge-adoption.aspx
21. National Organic Standards. www.ams.usda.gov/AMSv1.0/ams.fetchTemplateData.do?template=TemplateA&navID=NationalOrganicProgram&leftNav=NationalOrganicProgram&page=NOPNationalOrganicProgramHome&acct=AMSPW
22. “Food for Thought: Television Food Advertising to Children in the United States,” Kaiser Family Foundation, March 2007.