No, your eyes are not deceiving you. Our children are the heaviest they have ever been, with three times as many obese children and adolescents compared to the 1970s in the United States.
As medical providers, diagnosing children’s weight as healthy, overweight or obese is quite simple. We use a measurement called the Body Mass Index (BMI), which gives us a reference number based on a child’s weight and height for age. We compare this number to standardized curves, similar to growth curves, and if they are between the 5th and 84th percentile, they are at a healthy weight. If they are between the 85th and 94th percentile, they are overweight. If they are above the 95th percentile they are obese.
Eight Commandments for a Healthy Weight
- It is much better to talk with mouths full than to watch with mouths full. So: No eating in front of screens. Eat at the table. There is a clear correlation between hours of screen time and obesity.
- Non-educational screen time should also be limited to less than two hours a day.
- Pick the night of the week that you will eat out, and try to go somewhere that offers some alternatives to deep-fried foods, and no supersizing. In fact, avoid combination meals unless you are going to all share the fries and pop.
- We all should get five servings of fruits and vegetables a day. This may sound tough but it can be done affordably even for larger families, particularly if you buy from a farmers market or Costco (skip the prepared foods and samples). Fruits and veggies help fill you up with energy-neutral food, making less room available for energy-dense foods.
- Have your kids help prepare meals. They are more likely to eat healthier if they helped prepare it — fact! Also, preparing meals will burn extra calories.
- Then eat meals as a family, at least five times a week.
- Get a handle on sedentary habits. Set reasonable family goals for activity, like a 20- to 30-minute family walk three times a week, and go from there with the ultimate goal of 60 minutes of moderate activity a day.
- Try having your kids earn their screen time by being active, for example — one minute of activity (walking, riding, playing) earns two minutes of screen time, etc. You work out the ratio, keeping in mind that even the awareness of a need for activity is going to help. But be consistent and stick to the plan, even if it means just having kids stand during their screen time. Remember, standing burns up to 200 calories per hour, compared with 60 calories per hour for sitting and watching.
Today’s overweight child is tomorrow’s overweight adult, with all the associated medical costs and complications of being overweight. Hypertension, high cholesterol, Type 2 diabetes (with associated kidney disease), joint pain, headache, sleep disorders, irregular menses, behavior disorders, low self-esteem and depression are just a few of the consequences of the overweight epidemic that affects America’s youth.
Identifying those at risk is not hard; confronting the problem and pursuing change is.
Kids are overweight or obese because of a confluence of genetic, cultural and socio-economic factors. It is important to acknowledge that some individuals have a predisposition to being overweight — just as some individuals with a certain skin type are predisposed to sunburn. Genetic predisposition is not an excuse but a clinical indicator of a potential problem. We need to address this reality objectively.
But genetics aren’t solely to blame. We have a culture that cultivates inactive, calorie-laden living. Fast-food restaurants are crowded around schools; child and adolescent viewing hours on television are packed with commercials for foods and snacks of low nutritive value. The breadth of sedentary media experiences available to our children is overwhelming: cable TV, Internet access, videogames. In addition, the busy schedules of working parents may leave kids in empty houses with pantries full of Costco-sized snacks.
Change needs to start at home by taking charge of the calorie economy. We need to be able to count it to cut it. A rough guide is 1,000 to 1,500 calories per day in preschool, 1,500 to 2,000 calories per day in grade school and then it varies depending on gender during adolescence and adulthood between 2,000 and 3,000 calories per day. Over time, for approximately every 3,500 calories consumed beyond what is utilized, a pound will be gained — simple as that.
There are numerous resources for figuring out calorie content of various foods. One of my favorites is http://www.caloriecount.com. Here you’ll find an amazing array of information about the nutritional value of foods. It even gives foods grades — for examples apples get an A, cheddar cheese gets a D+. There’s also information on how many calories are consumed by engaging in myriad activities. For example disco dancing burns 300 calories an hour (probably due to embarrassment). Maybe you’d rather play the music than dance? Playing piano or trumpet burns 158 calories per hour. Nearly anything is better than the mere 60 calories an hour burned by sitting around watching TV.
As a community, there is no shortage of ways we can help encourage youth activity. Sports programs are obvious ways to get kids moving, but don’t forget about non-competitive exercise. For example, help support the Inland Northwest Land Trust, which works to preserve land for parks and nature centers. Scouting and outdoor-activity interest groups — even playing a musical instrument — all help get kids up off the couch. In short, we need to support activities that get our children to describe themselves with active words — like hiker, biker, swimmer, conservationist, player, helper — as opposed to descriptors like videogame champ or fan.
We have a problem that is growing bigger every year, and it is costing us big time. Decide as a family to make a change. Make a plan and carry it out. Check progress by keeping track of loss and gain. And be positive — focus on the effort to improve the health of the family and get the calorie economy under control. We can do it — we have to.
To help get a handle on nutrition, the USDA has put together an amazing site that can help you figure it all out at http://www.mypyramid.gov.