December 27, 2000

America's Kids Are Tipping the Scales

Childhood obesity is a national phenomenon

By Rhonda B. White, R.N., M.S.N.

Skipper Chong Warson

e all know that America's adults have gotten heavier every year, but more alarming still is the rising number of American children joining the ranks of the overweight. The most recent statistics from the U.S. Centers for Disease Control and Prevention (CDC) show that 14 percent of children between the ages of 6 and 11 are overweight. And the percentage has almost doubled in the past 20 years.

While there is a small number of people who are obese due to a medical condition, for the rest the reason is simple: Americans eat poorly and don't exercise. This applies to children as well as to adults. The CDC report for 1997 -- the most recent figures available -- shows that 80 percent of children don't participate in even moderate physical activity, which is classified as exercise for 20 minutes four days a week. The Healthy Eating Index, a publication of the U.S. Department of Agriculture that measures the diets of all Americans, shows that most small children and teenagers have a diet that is "poor" or "needs improvement."

What can we do as a nation to better our children's nutrition and decrease obesity? Short of outlawing fast-food restaurants that serve fatty meals and mandating 30 minutes of daily exercise, not much. The answer is education. The important lesson of a healthy lifestyle through good nutrition and exercise can be taught in school and government programs. Better than that, however, the lesson can begin at home.

No more potatoes on the couch!

Many of us have spent years eating poorly around our children. The term Happy Meal may be part of our child's vocabulary before the word apple. It isn't easy to change years of bad habits, but it is possible. Starting with something simple is often the key. According to many experts the first step is to turn off -- or at least turn down -- the television.

The important lesson of a healthy lifestyle through good nutrition and exercise can be taught through school and government programs. More importantly, however, the lesson can begin at home.

Thomas Robinson, M.D., assistant professor of pediatrics and medicine at Stanford University School of Medicine, is a leading researcher in the field of childhood obesity. Dr. Robinson published a significant study in the Journal of the American Medical Association (JAMA) that correlated decreased television-watching with weight loss in obese children.

Dr. Robinson has several suggestions that can help you to curb television use at home. Here are some of his ideas:

• Keep track of how much television your children are watching. Put a log by the television to keep track of the amount it is on.

• Make lists of things you and your children like to do, especially things that don't involve the television.

• Try a whole week without television, videos, or video games, and learn what other things you and your family can do with your time.

• Determine your television time budget for the week. Dr. Robinson suggests seven hours per week, or one hour per day.

• Create short-term rewards to make you feel good about staying under your television budget. (Watching television should not be one of them!)

Dr. Robinson's study was conducted with the help of local elementary schools. In the home it may be more difficult for parents to limit television watching. It's certainly not impossible, however. It's easiest to work on television reduction over a long period of time. Try limiting each child to one video and one television show per day and bit by bit, create other activities to occupy that time. I have been amazed at the things my children have done instead of watching television. We've spent days building forts, coloring, singing, and reading -- all pursuits that are more active and engaging than the tube.

Other suggestions relate to becoming more active throughout the day. Walk up the stairs instead of taking the elevator, exercise to a silly video with your children, and take a walk together as a family after supper.

Eat to live or live to eat?

Excessive television watching and a sedentary lifestyle are only part of the puzzle. But they have something in common with the other, larger problem of a poor diet: All are bad habits. What can we do to change our diet? Here are some very simple suggestions from the Weight-control Information Network, which is part of the National Institutes of Health:

• Be a role model for your children with your own diet.

• Teach your family healthy eating habits.

• Make a wide variety of healthful foods available in the house.

• Eat slowly, and eat together as a family as often as possible.

• Involve children in grocery shopping and meal preparation.

• Don't eat while watching television.

• Don't use food to punish or to reward a child.

• Exercise care when eating on the run outside the home. There are healthy choices even at fast-food restaurants.

Children are strongly influenced by their parents. If parents demonstrate a healthy lifestyle, provide children with good food to eat, and encourage physical activity, childhood obesity can be diminished. Together we can increase the number of healthy, active children in this nation -- one household at a time.

Related links:

• Rx.com magazine feature story: Pediatricians Give Media Exams: Has television become a health issue?

• Rx.com magazine column: Prevention & Primary Care: Young at Heart: Simple lifestyle changes keep you healthier

• Outside link: Weight-control Information Network (WIN)

• Outside link: The U.S. Department of Agriculture's Food and Nutrition Information Center

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