This article first appeared in the St. Louis Beacon: May 30, 2008 - A glimmer of hope may be appearing in the bleak landscape of our nation's childhood obesity epidemic. The number of children with a high body mass index has shown no increase from 1999 to 2006, according to an article published this week in the Journal of the American Medical Association. But experts warn that only cautious optimism is warranted.
The reason for the apparent leveling off is seen as a mystery. It could be sign of progress or, rather, that we have simply bottomed out. Or maybe we just can't get any fatter.
"It could be that our lifestyles are as bad as they can get," said Dr. Susan Myers, a pediatric endocrinologist at Cardinal Glennon Children's Medical Center. "Or it could be that some of the messages [about obesity prevention] are actually getting out. We don't have any idea which it is."
The study comes from Dr. Cynthia L. Ogden and her team at the U.S. Centers for Disease Control and Prevention. They analyzed trends in collective child and adolescent body mass index (BMI) using data from national health and nutrition surveys. The team found no significant changes in the prevalence of high BMI between 1999 and 2006.
Once ... twice ... three Times Fatter, the Children
The overall percentage of overweight or obese children in the United States has been growing at an alarming rate. In fact, childhood obesity rates are triple those of the 1960s and 1970s. Children (and families) are spending less time exercising and more time in front of the TV and computer. And busy families are putting far less effort into preparing nutritious, home-cooked meals, opting instead for meals of convenience -- often heavy on saturated fats and sugar.
And our perceptions are changing as well. "When I see a BMI at or below the 50th percentile, they almost appear too thin to me," Myers said. "Our perspectives have changed -- you forget what normal looks like."
The researchers found that 11.3 percent of children and adolescents aged 2 to 19 had a BMI at or above the 97th percentile (classified as significantly overweight), 16.3 percent had a BMI at or above the 95th percentile (classified as overweight), and 31.9 percent had a BMI at or above the 85th percentile (classified as "at risk" of being overweight).
Obesity: Taking Its Toll
While some argue that being overweight or obese is an individual consideration and a nuisance at worst, data show that it's a public health concern. "A menace," Myers says.
Overweight people may at some point face high blood pressure, high cholesterol, type 2 diabetes, respiratory difficulties, arthritis, disordered sleep patterns, and liver and gall bladder disease. When children are involved it means the risks begin at younger ages.
"Four percent of American adolescents currently have metabolic syndrome which places them at a high risk of coronary artery disease at a much younger age," Myers said. "And we have seen a huge epidemic of type 2 diabetes in the last 10 years. In the past, these people would have developed diabetes as adults but now it is happening at these younger ages simply due to obesity and lifestyle issues."
Some good news: preventing or treating obesity in children may reduce the risk of developing these conditions as they get older.
Fighting the Good Fight
The key to keeping all ages at a healthy weight is in taking a whole-family approach. And according to Myers, some of the best steps can be the most simple. "One simple thing I tell parents is to eliminate the sugar from what they are drinking." Get rid of the juice and soda and stick to water and other unsweetened beverages.
More advice: increase the intake of high-fiber foods, make healthier snack options more readily available and decrease fast food. "Ask yourself how often you are eating out or eating fast food," Myers said.
Myers noted that as many as one-third of American children are eating fast food daily. Sedentary lifestyles also come into play with children watching television as many as 1,500 hours a year, compared to 900 hours a year spent in school.
Along with cutting down on television, computer and video game, Myers encourages families to make exercise age-specific and, above all, fun. "If it's not fun, they're not going to do it," she said.
Bottom Line
In the meantime, we all await new findings in the battle against childhood obesity. "It is too early to know whether these data reflect a true plateau or a statistical aberration in an inexorable epidemic," state the authors of an editorial which accompanied the JAMA article. And they further caution that "without substantial declines in prevalence, the public health toll of childhood obesity will continue to mount."
More information
JAMA study: Abstract , Full Text (subscription or payment may be required),Editorial
For more information about Cardinal Glennon's weight management program: 314-577-5600
Dr. Cindy Haines is managing editor of Healthday-Physician's Briefing and president of Haines Medical Communications Inc., a full-service medical communications and consulting firm. As a board-certified family physician, Haines is well-versed in all areas of health care, with particular interest in fitness, nutrition, and psychological health.
Her weekly column on health care issues will appear here each Friday, and you can listen to Dr. Haines' House Call on KTRS.