Ask The Expert
Children

Every week there is a major story in the media about the epidemic of obesity. We see it on the street, at school, and perhaps in the mirror. The statistics are staggering:

• Greater than one third (>72 million) US adults are obese. This has doubled since 1980.¹
• 16% of 2-19 year old US children and adolescents are obese or > 95 percentile BMI for their age. This has tripled since 1980.¹
• In 2000, obesity related health care costs were estimated at $117.¹
• 400,000 deaths in 2000 related to unhealthy diet and physical inactivity.²
• In 1999-2000, 7% of US adolescents, 12-19 years old, had a form of Pre Diabetes, called Impaired Fasting Glucose (100-125 mg/dL).³
• In 2007, 7.8% of US adults have diabetes (includes diagnosed and undiagnosed).³
• The Centers for Disease Control and Prevention estimates that 1 in 3 people born in 2000 will develop type 2 diabetes in their life time.

According to the World Health Organization, the worldwide population is expected to more than double to an estimated 366 million cases by the year 2030. Why will there be so many more people with type 2 diabetes in the future? Unfortunately, you know the answer: It is the overweight children of today that contribute to the depressing statistics of tomorrow.

How did obesity become so out of control?

Our society is a breeding ground for obesity. However, overweight children don’t spontaneously appear. Children mirror their environment. If parents and other influential adults (such as teachers) are overweight and make poor health choices, the children will develop similar habits. Many children don’t control the food in the house, at school, or at restaurants-- adults do. Eating behavior guru, Ellyn Satter, RD, LCSW, reminds us that parents choose the type of food as well as the timing of meals and snacks, while the children decide how much or if they will eat. In other words, children finish eating when they are full, not when the plate is empty.

Portion Distortion

Unfortunately, many people have a distorted perception of appropriate portion size. The larger the serving size, the more we will eat. It doesn't help that the soft drink and food industry has increased serving sizes over the years to make us feel that we are getting our money’s worth.

• In fact, U.S. research has shown that in the past 20 years, the size of a standard hamburger has increased by 112% and bagels by 19%. Pasta servings are 480% larger and biscuits and cookies are 700% larger than they were 20 years ago.
• The serving size of an average soft drink increased from 13 ounces and 144 calories to nearly 20 ounces and 193 calories.*
• The average cheeseburger grew from 5.8 ounces to 7.3 ounces, increasing the calories from 395 to 533.* (*From DiabetesInControl.com: Food Portion Sizes Have Increased Dramatically in US)

When you consider that an additional 100 calories a day can add 10 extra pounds a year, you can see how these changes in portion perception can rapidly contribute to weight gain.

Interestingly, fruit and vegetable serving sizes have stayed the same, at about ½ cup. Why is it so difficult to get 5 servings of fruits and vegetables per day if a single serving is 3 times smaller than a can of soda? It is no coincidence that children who eat adequate fruits, vegetables, and milk have lower body weights.

Preventing Obesity is a Family Affair

What can parents, grandparents and concerned adults do to help prevent childhood obesity—and ultimately perhaps, also help prevent type 2 diabetes?

• Eat at least one daily meal together, as a family.
• Involve children in grocery shopping, food selection, meal planning and preparation.
• Teach children about label reading and appropriate portion sizes.
• Take at least one family outing per week that involves physical activity.
• Limit eating out, especially fast food, to 3 times per week or less.
• Limit children's screen time (TV, computer, etc) to 2 hours or less per day.
• Get involved with the food choices offered at schools. Or join forces with health and education leaders to improve children's nutrition and physical activity.
• Eat daily: 5 servings of fruits and vegetables, 3 eight ounce glasses of low or nonfat milk.
• Most importantly: lead by example. Replace the words "Do as I say, not as I do," with "Do as I do.”

Even if you choose just one action point, you will be making a difference in your life as well as in someone who looks up to you.

References:

1. Centers for Disease Control and Prevention, Obesity Halting the Epidemic by Making Health Easier, At A Glance 2009.
2. Mokdad A., Marks J., Stroup D., Gerberding J., Actual Causes of Death in the United States, 2000. JAMA March 10 2004, vol 291, #10, pp 1238-1245
3. Centers for Disease Control and Prevention, National Diabetes Fact Sheet, 2007