There is a growing body of evidence that the current problem of obesity can be traced back to childhood, even back to the womb. A recent post reported that 1 in every 5 4-year olds is overweight or obese. In this post I present the latest research updates on childhood obesity.

The growth charts and obesity

Researchers at the Harvard Medical School report that the rate of weigh gain during the few months of infancy is an indicator of risk for obesity later in life. The researchers did not only look at the weight gained by babies but also at the length as well as the weight-length relationship. After all, babies are growing in different dimensions. The study results suggests that babies who gain weight rapidly during the first few months are more likely to be overweight at early childhood, even as early as age 3. While this research brings good news to moms who worry because their babies are not gaining enough weight as specified in the growth charts, this is worrying news for moms like me whose kids did gain weight rapidly during the first few months after delivery. I had twin preemies, one of them clearly underweight, but somehow managed to almost catch up with his brother in just a few months. Both did gain weight fast mainly due to a combination of pumped breast milk and specially fortified formula for preemies – and well, the fact that they are such good drinkers. I’m glad to say, though at after almost 6 years, they never had any problems with weight due to a combination of proper diet and sufficient exercise.

BPA, phthalates and obesity

Some more bad news about phthalates and bisphenol A (BPA). Phthalates are those potentially carcinogenic chemicals found in cosmetics and other toilet products (including baby products!). BPA is the potentially harmful chemical found in plastic (including plastic baby bottles!). These two chemicals could potentially be linked to childhood obesity. Researchers at the Mount Sinai School of Medicine measured high levels of BPA and phthalates in the urine of overweight kids. These two chemicals are considered to be endocrine disruptors that interfere with hormones that regulate growth and development. More studies are needed to clarify their roles in childhood obesity.

One in five preschoolers are obese, according to researchers at Ohio State University. That adds up to half-a-million obese four year olds in America.

Baby fat is adorable, and even necessary for survival. Babies are designed to be fat, because fat is needed to help babies regulate their temperature. Those adorable little rolls around their tummies? Their sausage-y legs, fat little fingers, chubby cheeks and squidgy little knees? Precious.

As babies become crawlers and toddlers, and become more aware of the relationship between having a coat on and not being cold, being fat is not vital for survival. And crawling and toddling and running uses up calories and builds muscles, so that baby fat is designed to gradually disappear.

It seems like that isn’t happening in many of today’s children. Many people can tell you their opinion of why people are getting heavier, and getting heavier younger.  Perhaps our kids are getting less exercise, maybe they are eating more food, or the wrong kind of food. Perhaps it’s a combination.

Most of us know that a healthy diet and plenty of activity is vital for maintaining a healthy weight, and that seems to apply to everyone from babies on up.

And the researcher’s best non-obvious advice for preventing a baby becoming an overweight toddler and an obese preschooler?  Helping baby recognise when they are full. Babies are born knowing when they have had enough to eat, and trying to get a baby to eat more than she needs disrupts the natural system and may lead to overeating in future.

A panel of experts which included doctors and psychologists came up with a new model to fight childhood and adolescent obesity. The model consists of 7 steps, each step with increasing intensity.

The so-called Seven Steps to Success are

1. Medical Management. This step should be a joint effort between parents and pediatricians. The parents should have their child checked regularly for potential health problems caused by excess weight.
2. Education. This refers to educating parents and children alike on proper nutrition and physical exercise.
3. Environmental Changes. This entails making changes in the family environment, such as getting rid of all junk food, altering eating habits and schedules, limiting TV and computer time, and engagement in more outdoor, physical activities.
4. Support Groups. Support groups can great help kids, especially teens in coping with weight problems.
5. Cognitive-Behavior Therapy (CBT) I: Clinics or Short-Term Immersion. CBT is a scientifically based approach that helps people in motivation, goal-setting, and focusing skills. CBT can also be applied to weight problems and short-term immersion may be available in local hospitals, and clinics.
6. CBT II: Long-term Immersion. More intensive immersion programs are available in specially set up therapeutic boarding schools and clinics.
7. Bariatric Surgery +. This rather drastic measure is recommended to those who are seriously overweight and for whom the first six steps didn’t work.

One has to be aware that the model is based on one important assumption – that obesity among children is mainly linked to the family environment. The participation and commitment of the family members are therefore necessary for the model to work.

You can download the full article entitled for free

Seven Steps to Success: A Handout for Parents of Overweight Children and Adolescents

That’s what officials told a hopeful father in the UK. Damien and Charlotte Hall have been married for 11 years, and after trying unsuccessfully to have a baby of their own, decided to try to adopt a child.

But officials in the city of Leeds in northern England told Damien that he would have to lose weight first as his risk of becoming ill or dying was too high.

Damien weighs almost 350 lbs, but says he doesn’t drink or smoke, and says that he walks regularly and is very active.

There is no official upper weight limit for potential adoptive parents in the UK, but very overweight or obese people are likely to be turned down. The Adoption Panel in Leeds says that they are “unlikely to approve applicants with a BMI over 40 because of the long-term health risks.”

The Adoption Panel told the couple that Damien could have another medical in six months time, and they could reconsider their case if he lost weight.

The couple are sad and say that even though they accept that Damien is overweight, and know that he is more at risk from heart disease and other serious health issues, that he doesn’t feel unfit or unhealthy. They say that surely, life with loving parents is better than life in a children’s home, even with the higher chance that he may fall ill? After all, we never know what might happen to even the slimmest and fittest of us.

Currently, thousands of babies and children are awaiting adoption in the UK.

Is it right to discriminate against prospective adoptive parents because of their weight?

Chatting with some mom friends the other day, someone brought up the topic of information you would never, ever divulge to anyone else. And the top of the list of “questions I will never answer” was weight.

I had to reveal my weight to rent a snowboard the other day, so I can’t count myself amongst them, but  I certainly don’t feel comfortable talking about the actual figure. Turned out what I actually weigh is about 10 pounds away from my real weight.

I guess a lot of people don’t know our real weight. Or, we are in denial about how much we actually weigh. And it might be more important than habitually getting the wrong size when shopping for clothes. It seems that not having a realistic view of what you weigh affects weight gain in pregnancy.

Right, I’ll admit that. I gained 45lbs. Or 60lbs if you count from my lowest weight after my horrendous morning sickness finally went away.

According to Harvard University, perceptions of weight affect weight gain during pregnancy. Overweight and obese women who thought they weighed less than they actually did at the start of their pregnancies were much more likely to gain excessive weight during their pregnancy.

And strangely, healthy weight women who thought they weighed more than they actually did were much more likely to gain excessive weight.

Gaining excessive weight is linked to an increased risk of c-section, heavier babies, gestational diabetes, and a slightly increased risk or maternal mortality. And the more moms gain, the harder it is to lose.

Any mom will tell you that shifting pregnancy pounds while caring for a newborn is as hard as teaching someone as old as me to snowboard. Sorry, I won’t reveal my age either!

So basically, moms who had a realistic view of how much they weighed are more likely to gain a healthy amount of weight. What exactly is a healthy amount? It depends a lot on your starting weight, and your doctor will give you a target amount, but here’s rough guidelines of how much weight gain is normal.

Remember the old wives’ tale that everything should be chewed at least 20 times? Remember when our moms reprimanded us for “wolfing down” our food? However, don’t we sometimes wish that our kids would finish their plate and could just eat a little bit faster?

According to a recent study by Japanese researchers, people who eat fast have the tendency to be overweight. Men and women who are fast eaters are 84% and 50% (respectively) more likely to be overweight than those who consume their food at normal speed.

The reason for this, as Professor Ian McDonald to the University of Nottingham tells BBC, is the signaling system that tells the brain to stop eating when the stomach is full. If you eat too fast, the stomach is filled up before the gastric feedback signal kicks in so that the stomach can get overfilled.

There was a time when food was scarce and competition high so that eating fast had an evolutionary advantage. However, such a practice nowadays leads to obesity with serious health consequences. Scientists are therefore recommending that kids be encouraged to eat slowly and be allowed to stop when they feel they are full. (Mrs H, you were right when you wrote that “finish your plate” is not a good dining policy!). I hope I remember their recommendations next time I am tempted to say at the breakfast table “Eat quickly now or we’ll miss the bus!”

Based on this study, the terms “fast food” and “slow food” take a whole new meaning, although in the end the results are the same – extra pounds.

In a recently published Melbourne University research, 2 out of 5 parents of underweight or overweight children still believe their children is in the healthy weight range. Some other interesting findings:

• Children who are not in the average weight range, are also more likely to over or underestimate their body size
• A small number of parents believe their underweight children are overweight or that their overweight children are underweight.
• According to BMI, more children were classified as overweight, than compared to waist circumference.

The study has shown researchers that the way children’s weight and health classification is measured needs to be evaluated and changed. The study also aims to educate parents on what a healthy weight range should be for a particular child’s age and height. This would then signal to parents of overweight/underweight children to either boost a child’s nutritional intake or boost physical activity.

What you can do for your overweight child:

• Have your child’s evaluated by a physician specializing in pediatrics. They can best guide you in determining the proper weight range for your child.
• Decrease fat, greasy foods, cooked in transfat; decrease processed foods, sugary and salty snacks.
• Increase fruits, vegetables, and natural foods.
• Increase physical activity. Sign them up for karate, a group or individual sports, walk or ride a bike with them after school and on the weekends.
• Keep them out of the house doing sedentary activities like spending hours in front of the television or computer, or playing video games.
• Be a model of healthy eating and partake in physical activity yourself.
• Emphasize healthy eating, and physical activity, and not losing weight to your child.

What to do for your underweight child:

• Visit a pediatrician for an evaluation as well.
• Aside from the usual fruits and vegetables, for a very picky eater, pick a particular dish/treat that they like and pack it with calories. Examples include yogurt smoothies made with full fat yogurt and higher calorie fruits like bananas.
• Drizzle healthy olive oil in anything you can sneak into their stomachs.
• Don’t let them skip meals, and add plenty of snack times to the mix. Muffins or other calorie-packed snacks are a must, but balance them with fruits or vegetables snacks on alternate snack times or days.
• Don’t make meals unpleasant, but as relaxed and fun as possible. Eat as a family and focus on connecting as a family, instead of watching your child and counting each bite they take.
• Model healthy eating to your child.

After researching 8,150 infants at 9 months old, half were primarily cared for by someone other than the parents, the highlights of the study are as follows:

• 40% of infants who had been in daycare since 3 months of age were less likely to have been breastfed and were eating solids earlier than those cared for by parents.
• Babies in part-time care had gained 175 grams or 0.4 pounds more weight at 9 months than those who were cared for by their parents.
• Babies under other relatives’ care gained 162 grams or 0.35 pounds more weight, and also began eating solid foods earlier.

Why worry about the weight gain in babies? There have been enough studies consistent in their findings that early childhood weight gain can be a a precursor to being overweight as adults. These infants were also less likely to be breastfed understandably due to lack of time (daycare is more often a necessity because both parents are working). Breastfeeding has been linked by some studies, as offering some sort of protection against weight problems later in life.

Parents of children in daycare, what can you do? First, see if you can rearrange finances and schedule so one of you can stay at home full time, part time, or work from home. If that is not possible, be very clear in instructions with daycare staff as to what and when and how much they should be fed. Third, practice a healthy lifestyle of balanced diet and exercise for your babies to grow up emulating. You as parents, aren’t helpless against conclusions from research. And your child is not destined to become overweight just because they are in daycare.

A two-year experiment in five elementary schools in Philadelphia reduced obesity in kids.
And here`s how they did it:

? Sodas were replaced with fruit juices, water and low-fat milk.

? Snacks were scaled back in terms of fat, salt and sugar content.

? Candy was completely out.

? Raffle tickets for wise food choices were given out.

? Kids were encouraged to do exercise at activity stations during recess.

? Kids, parents, and teachers were given extra lessons about good nutrition.

The experiment included 1,349 pupils in grades four to six, 40% of which were overweight or obese at the start of the study. These pupils` weights were monitored and their food and exercise data were recorded. The diet changes were made to the food in vending machines and the school cafeteria.

Their results: The number of kids who gained excess weight in experimental schools dropped and was only about half compared to kids in schools with unaltered diet programs.

The results indicate school-mediated change in diet as well as physical activities seem to help mitigate obesity in children. However, such a program alone cannot fully resolve this rather ever-increasing problem. Despite the diet change, there were still plenty of newly recorded overweight kids in the five schools. True, it was less than in other schools with unaltered diets – 7 % vs 15 % – but 7% overweight kids is 7% too many.

The researchers suggest that such diet programs should start earlier and gym classes should be integrated. Furthermore, food sources outside school ? at home!!! ? should also be taken into account.

Source:

MSNBC, 7 April 2008

Related articles and posts on children obesity:

Balanced & Healthy Eating for Toddlers

Skipping Breakfast can make Teens Obese

Preventing Obesity in Young Children

A recent survey of more than 2,000 American adults revealed that parents of obese children do not see them as such. The survey pointed out that for children aged 6-11 who were obese, 43% of parents thought them to be ‘about the right weight?. Obesity was defined as a body mass index greater than 95 percentile of children nationwide.
This study is worth noting because as nutritionists point out, identifying obesity is an opportunity for parents to focus on improving their child’s diet and activity, especially since obese children are more prone to chronic health concerns such as diabetes, hypertension, and cholesterol problems.

When my parents visited us for 3 summers in a row from 2004-2006 (they hail from southern Texas), they were struck by a number of things inherent in the ‘European lifestyle’ that contrasted sharply with what they had observed in Americana that they thought contributed largely to a markedly low number of obese people they saw. These were what they pointed out:

1. Walking and biking were leisure and pleasure activities. In a university town like Leuven (where we live), you see not only high school children on bikes crowding the streets, but senior citizens and, quite remarkably and adorably, very young citizens on bikes. You see toddlers riding on bikes with training wheels on the sidewalks, or toddlers on bikes attached to the body of their parents? bikes with a thick long bar. If the kids aren’t biking, they’re walking several blocks to school. University students going home to their parents for the weekend can be seen lugging suitcases bursting with dirty laundry from their studentenkamer or kot (student room) to the station, boot heels clicking rapidly on the cobbled pavements. It’s a primary choice for many people from all ages: why drive a car or ride a bus when you can walk or bike?
2. Natural, brown bread was a staple along with the usual potatoes. A Vietnamese-American priest my parents met put it thus: ‘These Belgians eat bread for breakfast, bread for lunch, and bread for dinner. It’s just bread, bread, and even more bread!’ In between snacks at 10 AM and 4 PM consist of an apple (in the morning) and carrot or celery sticks (in the afternoon). You can wash this down with a bottle of sparkling (bruisend) water or a yogurt drink. During lunch and dinner, have a few slices of ham and cheese on hand, slice tomatoes and throw in some fresh lettuce and this should last you through the afternoon.
3. People were enjoying their meals with a cup of coffee or tea, or a pint of the local brew. And staying put. To engage in conversation. Letting the food digest slowly. Just being with friends. It is not unusual to see hordes of not only young adults standing in clusters in the town square or bus stops; you see children as young as 8 years old running around with their friends after school, teenagers sitting near the central library and just talking. Not rushing to get anywhere soon.

These three things, my parents noted, are some of the reasons they believe that they do not see to many obese people in Europe. The healthy respect and love for natural exercise such as walking and biking, the healthful diet that is widespread across the continent, and the penchant for whiling away the best part of the afternoon while sipping a glass of orange juice or red wine may just be some ways, they believe, that people in American might begin to enjoy life a little more while taking necessary steps towards improving one’s health life. What do you think? Do you agree with my parents?