Chubby & Sluggish help kids understand the benefits and rewards of exercise, healthy eating, and developing good personal cleanliness and safety habits.
Chubby and Sluggish provide a good example for kids that will last a lifetime.
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Sluggish (whose real name is Allie)
is a smart and curious 12 year old who
makes better food choices than Chubby,
but just doesn't exercise enough.
Sluggish's goal: Find fun exercises to
improve her stamina and share her
experiences on her website!
Chubby (whose real name is Eric)
is an active and energetic 12 year old who loves to exercise but eats too much junk
food. Eric tries to stay in shape, but his
eating habits hold him back.
Chubby's goal: Develop healthy
eating habits and help other kids
to do the same!
U.S. Babies Getting Fatter: Study
By Steven Reinberg, HealthDay Reporter
WEDNESDAY, Aug. 9 (HealthDay News) -- American babies carry more "baby fat" now than ever before, a new study finds.
Researchers say infants are 59 percent more likely to be overweight today than they were two decades ago.
"The obesity epidemic in our country has spared no age group, even our very youngest children," said lead researcher Dr. Matthew Gillman, an associate professor of ambulatory care and prevention at Harvard Medical School. "Overweight rates are going up in young children, and ours is the first study to show that they are going up in infants, in addition to toddlers and preschoolers," he said.
In the study of 120,680 children under six years of age, Gillman's team found that children, especially infants, are now more likely to be overweight. Looking at records collected from pediatricians working with a Massachusetts HMO for the years 1980 to 2001, they found that the prevalence of overweight children climbed from 6.3 percent to 10 percent during those 22 years. In addition, the proportion of children at risk of becoming overweight grew from 11.1 percent to 14.4 percent overall.
The report was published in the July issue of Obesity.
Infants had a 59 percent increased risk of being overweight, and the number of overweight infants increased by 74 percent, the researchers found. The data suggests that obesity prevention may need to start even before babies are born, Gillman said. There are a number of factors that appear to be responsible for the trend, he noted. The first is that women who become pregnant weigh more than they ever have, Gillman said, and "maternal body mass index is a determinate of infant weight at birth and after."
In addition, more mothers are putting on excess weight during pregnancy compared with decades past, Gillman said. "There is also an increase in type 2 diabetes and gestational diabetes among mothers, which are determinants of infant weight at birth and after birth," he added.
How babies are fed may also play a role. "Infants that are breast-fed tend to gain weight more slowly than formula-fed infants," the Harvard expert said.
Gillman said early weight gain can have dire consequences for long-term health. Studies suggest that gaining excess weight during the first months of life is associated with becoming overweight and developing high blood pressure years later. Other data suggests that infants who gain excess weight are more likely to suffer from wheezing, which can lead to asthma, Gillman noted.
"We need to think about preventing obesity at the very early stages of life," he said. "Women need to maintain exclusive breast-feeding for at least four to six months, as recommended by the American Academy of Pediatrics," he said.
One expert called the finding just one more facet of the ongoing obesity epidemic.
"This news is disturbing, but not surprising," said Dr. David L. Katz, an associate professor of public health and director of the Prevention Research Center at Yale University School of Medicine. "The progression from lean to overweight to dangerously obese occurs slowly, one pound at a time. The widely publicized increases in childhood obesity indicate that weight gain is beginning at an ever younger age. These data merely confirm the obvious," he said.
The message is disturbing for several reasons, Katz said. "As weight gain becomes problematic earlier in life, other chronic disease can be expected to do the same. If overweight becomes commonplace among babies, heart disease may well become commonplace among adolescents, as type 2 diabetes is already," he said.
The trend is also troubling because the nature of weight gain varies with age, Katz said. Infants and adolescents are far more adept at generating new fat cells than adults, he explained, and obesity caused by a high number of fat cells is harder to reverse than obesity caused by enlarging pre-existing fat cells.
"As difficult as weight control is for us, it will be that much harder, and more elusive, for our children," he said.
"The findings reported here are from a single HMO in one part of the country, but they contribute to an overwhelming body of evidence that childhood obesity is a crisis throughout the United States," Katz said.
Babies are 59% more
likely to be overweight
now than in 1980
Childhood Obesity
Causes
There are many factors that contribute to causing child and adolescent obesity. Some are modifiable and others are not.
Modifiable causes include:
•Physical Activity - Lack of regular exercise.
•Sedentary behavior - High frequency of television viewing, computer usage, and similar behavior that takes up time that can be used for physical activity.
•Socioeconomic Status - Low family incomes and non-working parents.
•Eating Habits - Over-consumption of high-calorie foods. Some eating patterns that have been associated with this behavior are eating when not hungry, eating while watching TV or doing homework.
•Environment - Some factors are over-exposure to advertising of foods that promote high-calorie foods and lack of recreational facilities.
Childhood Obesity Epidemic a Long-Term Challenge
By Karen Pallarito, HealthDay Reporter
THURSDAY, Sept. 20 (HealthDay News) -- In the 1980s and '90s, Americans tried to control their weight by watching their cholesterol by cutting dietary fat and substituting carbohydrates. They paid little mind to total calories and physical activity. And guess what happened to their waistlines -- and their children's?
"It was just an end run around the issue of health maintenance," said Dr. Henry C. McGill Jr., senior scientist emeritus at the Southwest Foundation for Biomedical Research in San Antonio, Texas. "And, of course, it crept over into kids, especially kids subjected to all of the advertising and offerings of high-density caloric food -- opportunities to avoid physical activity, attractions to television viewing and net surfing."
Today, more than one in three children and adolescents in the United States -- some 25 million kids -- are overweight or obese, according to the Robert Wood Johnson Foundation, which recently announced an unprecedented effort to reverse the childhood obesity epidemic by 2015. The Princeton, N.J.-based philanthropy said it plans to spend at least $500 million over the next five years on public health efforts focusing on kids and families in underserved communities.
It's the foundation's largest commitment ever. While the foundation has spent roughly as much in the area of tobacco over the years, "we never made the scale of that commitment up-front and public like we have with this," said Dr. James S. Marks, senior vice president and director of the foundation's health group.
"If we don't deal with children," he added, "this could be the first generation that will live sicker and die younger than its parents."
Scientists, physicians and public health advocates know that efforts to prevent obesity must start in childhood, because the problem leads to increased risk of coronary heart disease and other health hazards in adulthood. In fact, there's substantial evidence that obesity and related diseases, including diabetes and hypertension, can begin to exact damage during the teenage years.
In one landmark study, a group of researchers from across the United States analyzed post-mortem blood samples and evaluated atherosclerosis in coronary artery and aorta specimens from roughly 3,000 15- to 34-year-old men and women who died from causes such as accidents, homicide or suicide. One of the surprising results of the study, according to McGill, was that an elevated blood sugar -- as measured by levels of "glycohemoglobin" -- was associated in the late 20s and early 30s with about an 8-fold increase in advanced lesions in the coronary arteries. "It was a whopper of an effect," he said.
In another study, published in the Journal of the American Medical Association, researchers documented a significant upward shift over the past 16 years in blood pressure levels of children and teens aged 8 to 18. Lead author Paul Muntner, an epidemiologist at Tulane University School of Medicine, and colleagues said the increase in blood pressure levels is partially due to the increased prevalence of overweight in the United States.
And British researchers recently reported that children who are overweight at age 11 continue to have weight problems through their teenage years. Rates of overweight and obesity were highest among girls and children from lower socioeconomic backgrounds. The authors said the study highlights the need to target efforts to prevent obesity in the early years
.
But even as more money and manpower are devoted to obesity prevention, McGill said it may take many years to erase the epidemic. And, he added, it will take action on many different fronts, from educating children and physicians to improving the health-care financing system to include more preventive medicine.
"It was 1964 when the first U.S. Surgeon General's report came out, and just now, there's talk about the tide turning on cigarette smoking," he observed. "Obesity's perhaps going to take that long to get the tide turned."
It may take decades
to reverse the health
threats,experts say
Childhood Weight Problems Are Costly
Study finds annual health-care costs average $172 more for obese kids
-- Krisha McCoy
MONDAY, Jan. 9 (HealthDay News) -- Children who are overweight or obese have significantly higher health-care costs than their normal weight peers, say researchers from Children's Mercy Hospitals and Clinics and the University of Missouri-Kansas City School of Medicine.
It is estimated that 30 percent of children in the United States are obese or overweight. And more than 80 percent of obese 12-year-olds will be overweight adults.
For the study, which appears in the January issue of the Archives of Pediatrics, researchers assessed 8,404 children aged 5 to 18 who attended well-care visits in 2002 and 2003 at a primary-care clinic in the Midwest.
The researchers divided the children into three categories sased on their body-mass index: obese (BMI in the 95th percentile or higher), overweight (BMI between the 85th and 94th percentile) and healthy weight (BMI lower than 85th percentile).
The researchers measured the health-care costs for each child for one year after the initial visit.
Eighteen percent of the children were overweight, and 22 percent were obese.
Of the obese children, only 43 percent were diagnosed with obesity, suggesting a significant rate of under-diagnosis. The researchers were more likely to diagnose certain children with obesity.
"When obesity was present, being female, older and insured by Medicaid were associated with a higher probability of having diagnosed obesity," the authors wrote.
The overweight and obese children used significantly more laboratory services than did their healthy weight peers. The increase was most notable for the children with diagnosed obesity.
"We speculate that this increase reflects primary-care provider compliance with expert committee recommendations for laboratory evaluation of obese children and adolescents," the authors wrote.
The researchers estimated that, compared with their healthy weight peers, obese children had increased annual health-care costs of an average of $172.
Good Heart Health Habits Should Start in Childhood
Parents urged to act early to reduce future risk of disease
By Kathleen Doheny, HealthDay Reporter
THURSDAY, Jan. 18 (HealthDay News) -- TV commercials touting cholesterol-lowering remedies typically feature middle-aged men and women. The reason: That's when the soft, waxy substance can start to clog arteries, raising the risk of heart disease.
But experts say the focus on reducing threats to the heart should start much early, as soon as early childhood.
If more parents instilled heart-healthy habits from the time their children were toddlers, they could greatly reduce their kids' risk of future problems.
"The message is that a healthy diet early in life potentially has long-term benefits," Dr. Robert Eckel, a professor of physiology and biophysics at the University of Colorado, and former president of the American Heart Association, told HealthDay. "The idea that heart disease starts in the 50s has been substantially discounted. Saturated fat is always an enemy to the arteries, at any age."
The value of adopting a heart-healthy diet early in life is being demonstrated in an ongoing study in Finland, where researchers in 1990 began following more than 1,000 infants who were 7 months old at the time.
Half of the children were allowed an unrestricted diet, while the parents of the other half were directed to feed their children a diet low in saturated fats -- the unhealthy fats that are typically found in foods from animals. Those parents also received dietary and lifestyle counseling twice a year.
The benefits of the low-saturated fat diets and counseling were revealed in tests done when the children were 11. Ultrasound images of the boys' arteries found that those on the low-saturated fat diets had blood vessels that were better able to widen, allowing blood to flow more freely.
No such difference was seen for the girls, a finding reported for females in some adult studies. "The reason for this is not known, but one explanation could be estrogen," said study co-investigator Dr. Olli Raitakari, chief physician at the Turku University Central Hospital. Estrogen, the female sex hormone, influences the number of receptors for LDL cholesterol, the "bad" kind that clogs arteries, he said.
Still, the findings for the boys were very encouraging, Raitakari said, and the researchers believe the benefits for girls will eventually prove true. The study will continue until the children turn 20.
Alicia Moag-Stahlberg is a registered dietitian and executive director of Action for Healthy Kids, a partnership of more than 50 national organizations and government agencies that aims to correct America's epidemic of overweight, inactive and undernourished children by helping make changes in the schools.
She said U.S. based-guidelines don't recommend "any manipulation of fat under the age of 2 years." Dietary recommendations for children and teens from the American Academy of Pediatrics state that children 2 years old and older get a diet filled with fruits, vegetables, whole grains, low-fat and non-fat dairy, beans, fish and lean meats. The guidelines also recommends low amounts of saturated and trans fats.
After age 2 "is when you want to make sure you start to feed them a diet that embodies the dietary guidelines," said Moag-Stahlberg. If you do, you can be assured you are helping ensure your child's heart health, she said.
"Heart health means applying the dietary guidelines," Moag-Stahlberg said. "At home and at school, it's not just about not having candy and potato chips [to excess]. It's, are they getting enough of these other foods, along with physical activity."
The American Heart Association and the American Academy of Pediatrics recommend that children aged 2 to 3 years old eat a diet in which fats make up 30 percent to 35 percent of total calories.
By age 4 and continuing through the teens, fats should make up no more than 25 percent to 35 percent of total calories.
And parents can expect more help from schools to make sure their children are eating properly, Moag-Stahlberg said. Beginning with the 2006-07 school year, schools participating in the U.S. Department of Agriculture child nutrition programs must establish a local wellness policy to meet the requirements of the Child Nutrition and WIC (women, infants and children) Reauthorization Act.
The act, designed to combat the childhood obesity epidemic, calls for schools to offer more fruits and vegetables, milk, and better quality meats.
Parents can ask their school officials to outline the new policies for both nutrition and physical activity, Moag-Stahlberg said. "Ask, 'How are you going to meet the new goals?'" she said.
Childhood obesity: Make weight loss a family affair
By MayoClinic.com
Children can't change their exercise and eating habits by themselves. They need the help and support of their families and other caregivers. This is why successful prevention and treatment of childhood obesity starts at home.
Childhood obesity is usually caused by kids eating too much and exercising too little. So creating new family habits around healthy eating and increased physical activity can help a child lose weight and can also improve the health of other members of the family.
Change family behaviors
Many behaviors contribute to childhood obesity, whether it's the time spent in front of the TV or computer or the types and amounts of food eaten. These behaviors or habits are hard to change within a family, especially if members aren't ready, willing or able to make changes. Small, progressive steps can help. Keep in mind the following helpful hints.
•It's not a race. The first rule of change is to not make changes too quickly. It takes time and dedication to unlearn unhealthy behaviors and to develop new, healthy ones.
•Think small. Small, gradual changes are easiest to follow and incorporate into your daily lives. And small changes can make a big difference over time. Pick a few small changes that seem doable, for example, turning off the TV during dinner, switching from soda pop to milk or water, or taking a walk after dinner once a week.
•Set individual and family goals. Goals need to be achievable and measurable. Set specific goals for each family member, and then determine family goals. For example, your child's goal might be to eat fresh fruits and vegetables for afternoon snacks, and the family's goal might be to eat out at a fast-food restaurant only once a month.
The new changes might take some time getting used to. But stick to the plan as best you can and evaluate your progress. Sometimes goals need to be adjusted if they don't work for the family. It's better to create a new plan than to stick to one that isn't working.
Create a healthy-weight environment
As you work toward healthy habits and behaviors, create a home environment that supports these efforts. For example, make sure healthy foods are readily available. Serve fruits and vegetables with meals and remove high-calorie, high-fat foods from the home, buying them just occasionally.
A healthy-weight environment also means that exercise and physical activity are built into the day's routine. Encouraging the kids to play outside to ride bike or play a basketball game with friends, for example is a good way to keep kids active. Organize family outings that involve physical activity, such as walking to the library or playing at a park.
Parents can also set rules for the home that help reinforce the healthy lifestyle. For example, limiting the time spent watching TV or playing video or computer games encourages children to find other more active pastimes.
Other ways to create a healthy-weight environment:
•Remove sugar-sweetened drinks from the home.
•Offer more whole-grain foods with meals and snacks.
•Reduce the number of meals eaten out at fast-food and other restaurants.
•Sit down together for family meals and have that meal last at least 30 minutes.
•Remove TVs and computers from children's bedrooms.
•Include children in active chores, such as washing the car or walking the dog.
As your family establishes healthy behaviors, be sure that all members including parents stick to the plan. For example, if you take the TV out of your child's bedroom, make sure to take the TV out of your bedroom as well. Consistency is crucial to creating a healthy-weight home.
Be a positive role model
The best way to get your child on board with the new, active lifestyle is to commit to the changes yourself. Your actions teach your child what to eat, how much to eat and when to eat. You also encourage your child to be physically active every day if you make it a priority yourself.
Here's how you can be a positive role model:
•Eat more healthy, nutritious foods.
•Control your portion sizes.
•Limit the number of treats and high-calorie snacks you eat.
•Be physically active every day.
•Limit the amount of time you spend watching TV or playing computer games.
Reward successful changes
Rewards for successful behavior changes keep your family motivated and more inclined to stick to the plan. Make a list of how your family has succeeded in changing certain eating and activity habits. Then celebrate your success. Rewards should be consistent with the goal and be given regularly, such as on a daily or weekly basis.
Celebrating progress can be as simple as offering your child praise and attention, or it could be more involved. Planning an activity the family likes to do together, such as skating or swimming, is a good option. Don't use food as a reward or punishment, however. You might unintentionally lay the groundwork for food-related power struggles.
A challenge for today's family
Making changes can be challenging, especially when today's families juggle busy schedules, time and money constraints, and other stressors and demands on daily living. But if your family works together and supports each others' efforts, then success is more likely.
Eventually the new changes will be incorporated into your family's everyday life and will be just the way things are done. Once healthy habits become routine, you're well on your way to maintaining a healthy weight and improving your health as a family.
Keeping kids active: Ideas for parents
Children seem to become more sedentary every year, watching television and playing video games instead of biking to the playground or playing kickball in the backyard with their pals. Even schools have stopped emphasizing fitness. In some school districts, physical education has vanished completely because of underfunding.
Kids need regular exercise to build strong bones and muscles. Exercise also helps children sleep well at night and stay alert during the day. Such habits established in childhood help adolescents maintain healthy weight despite the hormonal changes, rapid growth and social influences that often lead to overeating. And active children are more likely to become fit adults.
As childhood has become more sedentary, children have put on weight lots of it. In the past 30 years, the rate of childhood obesity has more than tripled, leading to a dramatic increase in the number of children with type 2 diabetes, a disease once limited to sedentary, overweight adults.
The forces behind the obesity epidemic have been operating for several decades. They're pretty well beyond your control. But you do have the power to give your children a lifelong appreciation for activities that strengthen their bodies.
Set a good example
If you want an active child, be active yourself. Take the stairs instead of the elevator and park the car farther away from stores. Never make exercise seem a punishment or a chore. Find fun activities that the whole family can do together, such as:
•Swimming
•Nature hikes
•Cycling
•Canoeing
•Walks with the family dog
"If mom and dad exercise, it's a very powerful stimulus for a child to exercise," says Edward Laskowski, M.D., a specialist in physical medicine and rehabilitation and co-director of the Sports Medicine Center at Mayo Clinic, Rochester, Minn. "In addition to getting you active, exercising together gives you good family time. The key is to get kids moving. Free-play activities such as playing tag, hide-and-seek, hopscotch or jump-rope can be great for burning calories and improving fitness."
Limit screen time
"There are a lot of reasons why children are less active today, but the biggest culprit is the television set, followed closely by video games and computers," Dr. Laskowski says. "These activities encourage a sedentary lifestyle."
Watching television is directly related to childhood obesity. Children who watch more than five hours of television a day are eight times more likely to be obese than are children who watch less than two hours of television a day.
A surefire way to increase your children's activity levels is to limit the number of hours they're allowed to watch television each day. Other sedentary activities playing video and computer games or talking on the phone also should be limited.
Promote activity, not exercise
Children don't have to be in sports or take dance classes to be active. "Every kid is wired differently," says Dr. Laskowski. "We all have certain strengths and certain anatomical features and characteristics that permit us to do certain things better than others."
Many noncompetitive activities are available for a child who isn't interested in organized athletics. The key is to find things that your child likes to do. For instance, if your child is artistically inclined, go on a nature hike to collect leaves and rocks that your child can use to make a collage. If your child likes to climb, head for the nearest neighborhood jungle gym or climbing wall. If your child likes to read, then walk or bike to the neighborhood library for a book.
For a youngster interested in sports, however, involvement can be the basis for a variety of activities, including training for better performance and developing skills to play several sports. Before your child plunges into an organized sport or activity, learn as much as you can about:
•How much time you and your child will have to commit to practices and games
•How much participation and equipment will cost
•The characteristics of the sport for example, the relative emphasis it places on agility, speed, coordination, endurance and strength
•Your child's physical maturity
•The quality of instruction
•What benefits your child hopes to derive from it, and how you hope it will benefit him or her
Start young
Remember your energetic toddler? Direct that energy into a lifelong love of physical activity. For instance, have your child show you how bunnies hop, eagles fly or dogs wag their tails.
Some other suggestions for keeping kids interested:
•Play games your elementary school child loves, like tag, cops and robbers, Simon says and red light, green light. If you don't remember the rules for these games, make up your own or walk to your local library and check out a book on games.
•Let your toddlers and preschoolers see how much fun you can have while being active. Don't just run with them. Run like a gorilla. Walk like a spider. Hop like a bunny. Stretch like a cat.
•Plan your family vacations around physical activities hiking, biking, skiing, snorkeling, swimming or camping. Take along a ball or Frisbee disc to sneak in some activity at rest stops.
•Make chores a family affair. Who can pull the most weeds out of the vegetable garden? Who can collect the most litter in the neighborhood? Have your kids help shovel the snow off the driveway and use that excess snow to build a huge snow fort.
•Vary the activities. Let each child take a turn choosing the activity of the day or week. Batting cages, bowling and fast-food play areas all count. What matters is that you're doing something active as a family.
"By incorporating physical activity into our children's lives at an early age, we are setting the foundation for good fitness habits in the years to come," says Dr. Laskowski. "In fact, it can have a ripple effect on future generations and contribute to overall enhancement of public health."
One-Third of U.S. Kids Are Unfit
Researchers renew call for more physical activity to keep children healthy
MONDAY, Oct. 2 (HealthDay News) -- As many as one-third of American children aren't physically fit, a new study found.
Reporting in the October issue of the Archives of Pediatrics & Adolescent Medicine, the researchers found that boys tended to be in better shape than girls; older boys were more fit than younger boys; younger girls were more fit than older girls; and -- predictably -- heavier children were in worse shape than their slimmer counterparts.
"We are concerned, from a public health standpoint, that a third of kids don't meet fitness standards," said lead researcher Russell R. Pate, a professor of exercise science at the University of South Carolina's Arnold School of Public Health in Columbia. "The solution is for American youth to be more physically active than they are right now."
Being physically fit is an important key to maintaining healthy blood pressure and cholesterol levels and warding off many chronic diseases. But, since the 1980s, there has been a growing trend toward overweight and even obesity among American kids, with an estimated 15 percent of boys and girls between the ages of 6 and 19 now considered overweight. Much of that weight gain has been linked to a lack of exercise.
For the new study, Pate's team assessed the physical fitness of 3,287 children, ages 12 to 19. These children all participated in the National Health and Nutrition Examination Survey between 1999 and 2002.
To assess fitness levels, the researchers interviewed the children and also had them visit a mobile examination center, where they underwent a treadmill exercise test consisting of a two-minute warm-up, two three-minute periods of exercise, and a two-minute cool-down period.
During the test, researchers measured blood pressure, heart rate and rate of perceived exertion, determined by asking the children to rate how hard they felt their bodies were working. Heart-rate readings during the three-minute periods of exercise were used to estimate the amount of oxygen used by the body during maximum exertion.
Overall, only about 65 percent of the children were judged physically fit.
Pate's group found that fitness levels were higher in boys than in girls and in children who were of normal weight, compared with overweight children. In addition, older boys were more physically fit than younger boys, while younger girls were more fit than older girls.
Also, children who watched a lot of television or played hours of video games and those who spent less time being physically active were less likely to be fit.
"Kids need to be involved in more quality after-school sports programs," Pate said. "More kids need to be provided with physical-education classes in their schools," he added.
Pate also thinks that children need to be more active in their everyday lives -- for example, riding a bike to school or walking. "This is going to call for some major changes in the way our society is organized and in the expectations that we have of ourselves and our children," he said. "That's probably what it's going to take."
One expert believes it's going to take a concerted effort by parents and schools to increase the amount of physical activity that children get.
"The links between overweight and poor physical fitness are especially ominous in light of the steadily rising rate of childhood obesity in the U.S. and much of the world," said Dr. David L. Katz, an associate professor of public health and director of the Prevention Research Center at Yale University School of Medicine.
American culture encourages overeating and under-activity in many ways, from labor-saving devices, to clever marketing strategies, to the variety of tasty processed foods accessible almost everywhere, almost all the time, he noted.
"To counter this, we need a force that is not just opposite, but equally strong," Katz said. "We need to find creative ways to get physical activity into the school day every day. We need parents who engage their children in physical activity by making it part of the family routine. We need neighborhoods that provide recreational facilities and parents who set limits to TV and computer time and send their kids out to play."
Prevention
Teaching healthy behaviors at a young age is important since change becomes more difficult with age. Behaviors involving physical activity and nutrition are the cornerstone of preventing obesity in children and adolescents. Families and schools are the two most critical links in providing the foundation for those behaviors.
Families
Parents are the most important role models for children. Results from an American Obesity Association survey show that:
•The majority of parents in the U.S. (78 percent) believe that physical education or recess should not be reduced or replaced with academic classes.
•Almost 30 percent of parents said that they are "somewhat" or "very" concerned about their children's weight.
•12 percent of parents considered their child overweight.
•Comparing their own childhood health habits to their children's, 27 percent of parents said their children eat less nutritiously, and 24 percent said their children are less physically active.
•35 percent of parents rated their children's school programs for teaching good patterns of eating and physical activity to prevent obesity as "poor," "non-existent," or "don't know."
•Among six choices of what they believed to be the greatest risk to their children's long-term health and quality of life, 5.6 percent of parents chose "being overweight or obese." More parents selected other choices as the greatest risk: alcohol (6.1 percent), sexually transmitted disease (10 percent), smoking (13.3 percent), violence (20.3 percent), and illegal drugs (24 percent).
•In terms of their own behavior, 61 percent of parents said that it would be either "not very difficult" or "not at all difficult" to change their eating and/or physical activity patterns if it would help prevent obesity in any of their children.
The AOA's survey results indicate that parents understand the importance of regular physical education for their children. Their unfamiliarity or inadequate rating of their children's school obesity prevention program is likely due to the lack of programs across the nation.
Parents appear to underestimate the health risk of excess weight to their children, and the difficulty in achieving and maintaining behavioral changes associated with obesity prevention. Additional studies are needed to develop appropriate public health programs to better educate parents in identifying and understanding changes in their children's weight, to incorporate the family in prevention efforts, and to improve school-based obesity prevention programs that include increasing physical education classes.
• For more details on AOA's survey, read the Executive Summary.
Here are some ways that parents can establish a lifetime of healthy habits for their family:
Create an Active Environment:
•Make time for the entire family to participate in regular physical activities that everyone enjoys. Try walking, bicycling or rollerblading.
•Plan special active family-outings such as a hiking or ski trip.
•Start an active neighborhood program. Join together with other families for group activities like touch-football, basketball, tag or hide-and-seek.
•Assign active chores to every family member such as vacuuming, washing the car or mowing the lawn. Rotate the schedule of chores to avoid boredom from routine.
•Enroll your child in a structured activity that he or she enjoys, such as tennis, gymnastics, martial arts, etc.
•Instill an interest in your child to try a new sport by joining a team at school or in your community.
•Limit the amount of TV watching.
Create a Healthy Eating Environment:
•Implement the same healthy diet (rich in fruits, vegetables and grains) for your entire family, not just for select individuals.
•Plan times when you prepare foods together. Children enjoy participating and can learn about healthy cooking and food preparation.
•Eat meals together at the dinner table at regular times.
•Avoid rushing to finish meals. Eating too quickly does not allow enough time to digest and to feel a sense of fullness.
•Avoid other activities during mealtimes such as watching TV.
•Avoid foods that are high in calories, fat or sugar.
•Have snack foods available that are low-calorie and nutritious. Fruit, vegetables and yogurt are some examples.
•Avoid serving portions that are too large.
•Avoid forcing your child to eat if he/she is not hungry. If your child shows atypical signs of not eating, consult a healthcare professional.
•Limit the frequency of fast-food eating to no more than once per week.
•Avoid using food as a reward or the lack of food as punishment.
Schools
Outside of the home, children and adolescents spend the majority of their time in school. So, it makes sense that schools provide an environment that promotes healthy nutrition and physical activity habits. Only a few creative programs are being tested in schools across the country.
Overweight and Obesity
Results of a 1999 national survey showed that 16 percent of high school students were overweight (Body Mass Index (BMI) greater than the 85th percentile and below the 95th percentile) and nearly 10 percent were obese (BMI more than or equal to the 95th percentile). Self-reported height and weight was used. The survey, called the Youth Risk Behavioral Surveillance System (YRBSS), is conducted by the Centers for Disease Control and Prevention (CDC), and uses a nationally representative sample of students in grades 9 to 12.
Here are more results from the 1999 YRBSS:
•More male students (17 percent) were overweight than female students (14 percent), and obese (12 percent of males and 8 percent of females).
•More black students (22 percent) were overweight than white students (14 percent).
•More black and Hispanic female students (23 and 18 percent, respectively) were overweight than white female students (12 percent).
Self-Perception of Weight
•When asked to describe their weight, 30 percent of students thought of themselves as overweight.
•More female students (36 percent) than male students (24 percent) considered themselves overweight.
•More Hispanic students (37 percent) than white and black students (29 and 25 percent, respectively) considered themselves overweight.
Weight Loss Attempts
•43 percent of students reported that they were trying to lose weight.
•More female students (59 percent) than male students (26 percent) reported that they were trying to lose weight.
•More Hispanic students (51 percent) reported that they were trying to lose weight than white students (43 percent) and black students (36 percent).
Methods of Weight Loss:
Exercise
•More than half (58 percent) of students reported the use of exercise (during the 30 days before the survey) to lose weight or to avoid gaining weight.
•More female students (67 percent) reported the use of exercise for weight loss or maintenance than male students (49 percent). More white female students (70 percent) reported the use of exercise for weight loss or maintenance than black female students (59 percent).
Change of Eating Behaviors
•40 percent of students reported that they ate less food, fewer calories, or foods low in fat (during the 30 days before the survey) to lose weight or to avoid gaining weight.
•More female students (56 percent) reported that they ate less food, fewer calories, or foods low in fat than male students (25 percent) to lose weight or to avoid gaining weight.
•More white students (42 percent) reported that they ate less food, fewer calories, or foods low in fat than black students (34 percent) to lose weight or to avoid gaining weight.
•More white female students (60 percent) reported that they ate less food, fewer calories, or foods low in fat than Hispanic female students (51 percent) and black female students (43 percent) to lose weight or to avoid gaining weight.
Fasting
•13 percent of students reported fasting ("without eating for 24 hours or more" ) to lose weight or to avoid gaining weight.
•More female students (19 percent) reported fasting than male students (6 percent) to lose weight or to avoid gaining weight
Use of Dietary Supplements
•8 percent of students reported taking diet pills, powders, or liquids without a doctor's advice to lose weight or to avoid gaining weight.
•More female students (11 percent) reported taking diet pills, powders, or liquids without a doctor's advice than male students (4 percent) to lose weight or to avoid gaining weight.
•More white female students (12 percent) reported taking diet pills, powders, or liquids without a doctor's advice than black female students (6.9 percent) to lose weight or to avoid gaining weight.
Purging / Laxative Use
5 percent of students reported vomiting or taking laxatives to lose weight or to avoid gaining weight.
•More female students (7 percent) reported vomiting or taking laxatives than male students (2 percent) to lose weight or to avoid gaining weight.
•Find more 1999 YRBSS results from the CDC's Morbidity and Mortality Weekly Report and from the CDC's Youth '99 Online Analysis.
Creating a Healthy Eating Environment in Schools
Recommended daily servings of fruits and vegetables are not being met by today's youth. According to the Centers for Disease Control and Prevention, "51 percent of children and adolescents eat less than one serving a day of fruit, and 29 percent eat less than one serving a day of vegetables that are not fried."
According to the U.S. Department of Agriculture (USDA), children drink 16 percent less milk now than in the late 1970's, and 16 percent more of carbonated soft drinks. The consumption of non-citrus juices such as grape and apple mixtures increased by 280 percent.
A coalition of five medical associations and the USDA proposed a "Prescription for Change: Ten Keys to Promote Healthy Eating in Schools" to be used for guidance in school nutrition programs. Their prescription is:
1.Students, parents, food service staff, educators and community leaders will be involved in assessing the school's eating environment, developing a shared vision and an action plan to achieve it.
2.Adequate funds will be provided by local, state and federal sources to ensure that the total school environment supports the development of healthy eating patterns.
3.Behavior-focused nutrition education will be integrated into the curriculum from pre-K through grade 12. Staff who provide nutrition education will have appropriate training.
4.School meals will meet the USDA nutrition standards as well as provide sufficient choices, including new foods and foods prepared in new ways, to meet the taste preferences of diverse student populations.
5.All students will have designated lunch periods of sufficient length to enjoy eating healthy foods with friends. These lunch periods will be scheduled as near the middle of the school day as possible.
6.Schools will provide enough serving areas to ensure student access to school meals with a minimum of wait time.
7.Space that is adequate to accommodate all students and pleasant surroundings that reflect the value of the social aspects of eating will be provided.
8.Students, teachers and community volunteers who practice healthy eating will be encouraged to serve as role models in the school dining areas.
9.If foods are sold in addition to National School Lunch Program meals, they will be from the five major food groups of the Food Guide Pyramid. This practice will foster healthy eating patterns.
10.Decisions regarding the sale of foods in addition to the National School Lunch Program meals will be based on nutrition goals, not on profit making.
• Read more recommendations from this coalition of medical associations and the USDA in, Healthy School Nutrition Environments: Promoting Healthy
Eating Behaviors.
Creating an Active Environment in Schools
Nationwide in 1999, approximately 56 percent of high school students were enrolled in a physical education (PE) class and only 29 percent attended PE class daily, according to the Center for Disease Control and Prevention's (CDC) Youth Behavioral Risk Factor Surveillance System (YRBSS). Participation in high school sports was 55 percent, with a higher participation rate from male students (62 percent) than females (48 percent).
The CDC partnered with experts from other federal agencies, state agencies, universities, voluntary organizations, and professional associations to develop Guidelines for School and Community Programs to Promote Lifelong Physical Activity Among Young People. The 10 recommendations in the guidelines are:
1. Policy
Establish policies that promote enjoyable, lifelong physical activity.
•Schools should require daily physical education and comprehensive health education (including lessons on physical activity) in grades K-12.
•Schools and community organizations should provide adequate funding, equipment, and supervision for programs that meet the needs and interests of all students.
2. Environment
Provide physical and social environments that encourage and enable young people to engage in safe and enjoyable physical activity.
•Provide access to safe spaces and facilities and implement measures to prevent activity-related injuries and illnesses.
•Provide school time, such as recess, for unstructured physical activity, such as jumping rope.
•Discourage the use or withholding of physical activity as punishment.
•Provide health promotion programs for school faculty and staff.
3. Physical Education Curricula and Instruction
Implement sequential physical education curricula and instruction in grades K-12 that
•Emphasize enjoyable participation in lifetime physical activities such as walking and dancing, not just competitive sports.
•Help students develop the knowledge, attitudes, and skills they need to adopt and maintain a physically active lifestyle.
•Follow the National Standards for Physical Education.
•Keep students active for most of class time.
4. Health Education Curricula and Instruction
Implement health education curricula and instruction that
•Feature active learning strategies and follow the National Health Education Standards.
•Help students develop the knowledge, attitudes, and skills they need to adopt and maintain a healthy lifestyle.
5. Extracurricular Activities
Provide extracurricular physical activity programs that offer diverse, developmentally appropriate activities both noncompetitive and competitive for all students.
6. Family Involvement
Encourage parents and guardians to support their children's participation in physical activity, to be physically active role models, and to include physical activity in family events.
7. Training
Provide training to enable teachers, coaches, recreation and health care staff, and other school and community personnel to promote enjoyable, lifelong physical activity among young people.
8. Health Services
Assess the physical activity patterns of young people, refer them to appropriate physical activity programs, and advocate for physical activity instruction and programs for young people.
9. Community Programs
Provide a range of developmentally appropriate community sports and recreation programs that are attractive to all young people.
10. Evaluation
Regularly evaluate physical activity instruction, programs, and facilities.
The Emotional Toll of Obesity
From KidsHealth.org
Three times as many 6- to 17-year-olds are overweight now than 30 years ago. And the epidemic of alarming proportions is only getting worse some researchers project that nearly half of the kids in North America will weigh too much by 2010.
Being overweight or obese can significantly affect kids' daily way of life, potentially causing serious physical and psychological problems now and in the future, says a recent study. Researchers from Yale University and the University of Hawaii at Manoa pored through 40 years of findings to analyze the extensive, often endless stigma that overweight children commonly endure.
According to the study, kids and teens carrying around excess pounds may be the targets of bias and stereotyping not only from their peers, but also teachers and, surprisingly, their parents. Kids who are overweight frequently experience unfair treatment, prejudice, and discrimination, says the study, and are often:
•prone to low self-esteem, depression, and suicidal thoughts
•teased, bullied, or rejected by peers (even as early as preschool)
•more likely to develop unhealthy dieting habits and eating disorders, such as anorexia nervosa and bulimia
Overweight children are also already at risk for conditions once thought only to affect adults (like type 2 diabetes, high blood pressure, and high cholesterol). And, according to the study, the cruel treatment and social disadvantages associated with being overweight may have lasting, harmful effects on everything from kids' physical health to their education, from their relationships to their jobs.
That's why the researchers say discrimination of overweight kids and teens is just as serious an issue as "racial discrimination or discrimination against children with physical disabilities."
What This Means to You
