In 1997, the World Health Organization declared obesity a global epidemic with major health implications. The health implications are numerous. Hypertension, Diabetes, poor sleep and poor self-esteem are just a few. Up to 80% of obese youth continue the trend into adulthood. Some parents feel they do not have the resources or knowledge to fully help their children to get healthy but they truly do. At South Suburban Family Health(SSFH) we will give parents and children the tools needed to take control of their weight.
There are many factors that contribute to obesity. Some children may have specific medical or genetic conditions that can be associated with obesity.
There are specific nutritional factors that contribute to the increase in obesity rates, as well, and include, (1) insufficient infant breast feeding, (2) a reduction in fiber, fruit and vegetable intake and (3) the excessive consumption of oversized fast-foods and soda. Although, nutritional issues have a significant role to play, decreased energy expenditure (i.e. lack of exercise, excessive sedentary behaviors) is equally responsible for this increase in obesity in our youth. Children and youth are more inactive than ever. With the widespread availability of television, videos, computers and video games, children are not as active today. The National Health and Nutrition Examination Survey indicated that 26% of American children (43% of African –American children, up to 33% of Hispanic children) watch at least 4 hrs of television per day. These children were also more overweight than those who watched less than 2 hours of television per day.
Not only are rates of sedentary activities increasing, participation in physical activity outside of school is not adequate. There are many factors that put particular individuals at risk of having low levels of physical activity. Children living in poverty, children with disabilities, children living in apartments or public housing and children living in neighborhoods where outdoor physical activity is restricted by safety concerns or lack of facilities. These issues take time and joint effort among different groups in order to solve them.
The successful treatment of obesity in children is multidimensional. A program that includes dietary counseling and modification, exercise and family-based behavioral modification is ideal and has been shown to produce enhanced weight loss and better maintenance of weight loss over 5 years. Improvements in weight have been shown to occur when television viewing is restricted to less than 2 hours per day! The American Academy of Pediatrics recommends no more than 2 hours of quality television programming per day for children over 2 years of age.
Given the challenges that exist in reversing obesity, preventive tactics are likely to be the key to success. Physical activity needs to be promoted at home, in the community and at school. Each school or school district is required to set goals for healthy nutrition, physical activity and other strategies to promote student wellness.
Age-Appropriate Recommendations for Physical Activity
Infants and Toddlers
The AAP recommends that children younger than 2 years not watch any television. Parents should be encouraged to provide safe, nurturing, and minimally structured play environment for their infant. Infant and toddlers should be allowed to develop enjoyment of outdoor physical activity and unstructured exploration. Such activities include walking in the neighborhood, unorganized free play outdoors, and walking through a park or zoo.
Preschool-Aged Children (4-6Years)
Free play should be encouraged with emphasis on fun, playfulness, exploration and experimentation. Appropriate activities might include running, swimming, tumbling, throwing and catching. Limit television time to less than 2 hours per day.
Elementary School Aged Children (6-9 Years)
In this age group, children improve their motor skills, visual tracking, and balance. These children should be encouraged to walk, dance, or jump rope and may enjoy playing miniature golf. Organized sports (soccer, baseball) should have flexible rules, allow free time in practices and focus on enjoyment rather than competition.
Middle School aged Children (10-12 Years)
Focus on enjoyment with family members and friends should be encouraged. Weight training may be initiated, provided that the program is well-supervised, that small free weights are used with high repetitions, that proper techniques is demonstrated and that shorter sets using heavier weights and maximum lifts are avoided.
Adolescents are highly social and influenced by their peers. Identifying activities that are of interest to the adolescent, especially those that are fun and include friends, is crucial for long term participation. Physical activities may include dance, yoga, running, walking, cycling or even household chores. Competitive and non-competitive sports are also included.
The prevalence of pediatric obesity has reached epidemic proportions. The promotion of decreased caloric intake and increased energy expenditure is crucial if we are to be successful in decreasing childhood obesity. Making exercise alternatives as exciting, attractive, and enjoyable as video games, convincing school boards to fund Physical Education and other school-based physical activity opportunities and changing consumer attitudes about food selection and portion sizes are among our challenges. We must continue to educate ourselves and our children about the choices we make and the impact for our health today and in the future.
For more information on combating childhood obesity contact Dr. Michelle Meeks or Dr. Tonja Austin at South Suburban Family Health, 708-672-1600.