Childhood Obesity: How it Happened and What we can Do
Since 1980, childhood obesity rates have tripled, with almost one-third of children aged 2 to 18 years old now overweight or obese.4 More than 80% of today’s children will be overweight or obese by 2030 (100% by 2024).5 The life expectancy of today’s youth is expected to be shorter than that of their parents.3 Obese children have an increased risk of type 2 diabetes, hypertension, sleep apnea, mental health problems, and orthopedic conditions. In fact, 1 in 3 children will eventually develop type 2 diabetes.6 It’s not hard to imagine a future of children tethered to lancets, glucometers, medications, and weekly visits to not only
primary care physicians, but also to multiple specialists. Many of these kids will be depressed, suffer from anxiety, have low self-esteem, and won’t be able to reach their academic potential. From an economic standpoint, this future burden will cost the U.S. $861-$957 billion dollars in healthcare costs.5 There are many reasons that have led to the childhood obesity problem, including gym class and after school sports being cut, cheaper cable TV, technologically advanced video games, the internet, increased portion sizes, and more fast food restaurants and vending machines with processed foods.2 Meanwhile, the fitness industry has continued to grow and specialize. In the United States, club attendance has grown by more than half in the last 20 years. According to
the American Kinesiology Association, the number of undergraduate kinesiology majors grew 50% from 2003 to 2008, to more than 26,000 students, making it one of the fastest growing majors in the country. There are hundreds of certifying agencies and companies that fitness professionals can get certified through, specializing in such areas as children, adolescents, and youth. However, with no governing body over certifications, and no real cohesive organizational structure of the industry existing, an unorganized atmosphere is manifested which allows for unprofessional and sub-par fitness trainers and coaches. Furthermore, tight school budgets make physical education a low priority. Only six states currently require physical education in every grade level.3 Most significant federal programs administered through the past few decades are either unfunded or very lax with no oversight, and have proven ineffective in reducing the prevalence of obesity in school children.3 Parents are working longer hours than they did 20 years ago, commute times are longer, and computers and TV’s distract from the traditional family dinner, where the family gathers around the table and engages in healthy dialogue which models good behavior. Many children eat meals in the car now from drive thru’s, and working mom’s lack the time for properly prepared healthy meals for their children. Many physicians are aware of the clinical guidelines to address the problem, but unfortunately, most today are frustrated with the health care delivery system where they are forced to practice modern medicine in a healthcare system that is largely reactive (treating disorders) versus proactive (preventing disease). While recent major federal health care reform was passed into law, many of its components have not gone into effect yet; therefore, it is still too early to collect data and results on its total effectiveness and impact on improving quality, access, and reducing costs.
primary care physicians, but also to multiple specialists. Many of these kids will be depressed, suffer from anxiety, have low self-esteem, and won’t be able to reach their academic potential. From an economic standpoint, this future burden will cost the U.S. $861-$957 billion dollars in healthcare costs.5 There are many reasons that have led to the childhood obesity problem, including gym class and after school sports being cut, cheaper cable TV, technologically advanced video games, the internet, increased portion sizes, and more fast food restaurants and vending machines with processed foods.2 Meanwhile, the fitness industry has continued to grow and specialize. In the United States, club attendance has grown by more than half in the last 20 years. According to
the American Kinesiology Association, the number of undergraduate kinesiology majors grew 50% from 2003 to 2008, to more than 26,000 students, making it one of the fastest growing majors in the country. There are hundreds of certifying agencies and companies that fitness professionals can get certified through, specializing in such areas as children, adolescents, and youth. However, with no governing body over certifications, and no real cohesive organizational structure of the industry existing, an unorganized atmosphere is manifested which allows for unprofessional and sub-par fitness trainers and coaches. Furthermore, tight school budgets make physical education a low priority. Only six states currently require physical education in every grade level.3 Most significant federal programs administered through the past few decades are either unfunded or very lax with no oversight, and have proven ineffective in reducing the prevalence of obesity in school children.3 Parents are working longer hours than they did 20 years ago, commute times are longer, and computers and TV’s distract from the traditional family dinner, where the family gathers around the table and engages in healthy dialogue which models good behavior. Many children eat meals in the car now from drive thru’s, and working mom’s lack the time for properly prepared healthy meals for their children. Many physicians are aware of the clinical guidelines to address the problem, but unfortunately, most today are frustrated with the health care delivery system where they are forced to practice modern medicine in a healthcare system that is largely reactive (treating disorders) versus proactive (preventing disease). While recent major federal health care reform was passed into law, many of its components have not gone into effect yet; therefore, it is still too early to collect data and results on its total effectiveness and impact on improving quality, access, and reducing costs.
The prospect of reducing childhood obesity to pre-1980 rates is daunting. It’s going to require synergistic efforts on behalf of parents, schools, pediatrics/ physicians, the fitness industry, communities and governments. Should one of these components under perform, the chance of solving this epidemic will be severely compromised. Fitness professionals must continue to stay educated via university degrees, reputable certifications, and CEU’s to understand
the unique biomechanical and physiological nature of children. Fitness professionals must reach out to their local communities, faith based organizations, and schools to offer their support, resources, and solutions for healthy kids. The fitness industry as a whole must work together more cohesively to set standards, hold poor performers accountable, and spotlight their service as an important solution to childhood obesity. The fitness industry must also continue to build strong relationships with the medical community and communicate more effectively with physicians and doctors. Physicians must be more aware of the clinical guidelines to helping combat childhood obesity including: to assess all children annually for weight status and body mass index for age, to evaluate dietary patterns and physical activity and sedentary behaviors at each well-child visit, to offer appropriate lifestyle messages to all children, and to deliver appropriate assessment, counseling, and treatment to children who are already overweight or obese.4 They must believe it’s more of a personal and ethical responsibility. Parents must adhere to any doctor recommendations of exercise prescription and understand the value of their investment in adopting a healthier for hemselves and their kids, whether it’s covered by their health insurance or not. More than 95% of all children and adolescents between the ages of 5 and 17 are enrolled in school.3 Since schools have continuous and intensive contact with youth during the first two decades of their lives, they must swiftly implement healthy lifestyle components into their curriculum. For instance, it can be designed in such a way that incorporates a portion of nutrition education into the core subjects. For example, students could learn about the number of calories and proportions of the food pyramid in math class, a daily food and activity journal could be utilized in a writing unit, and books about eating healthy could be used for reading assignments.3 Local, state, and federal governments must do more to provide incentives for healthy communities; such as parks, playgrounds, bike paths, and open spaces. They must encourage, recognize and support
community and civic groups such as Chamber of Commerce’s, Jaycees, Kiwanis, Rotary, etc. to run health promoting events such as local charity run walks,
fitness challenges, and health fairs. The federal government should implement a conditional spending grant that allows for schools to receive additional funding as an incentive for incorporating nutrition and exercise education into their curriculum. Conditional spending has proven to be an effective method of encouraging states to act.3 There should be more public health investigations into things such as soda, fast food, and other sectors of the food industry, and it must continue to be vigorous and expose and challenge the many ways the food industry creates a toxic environment that exploits children through targeted marketing and exacerbates the obesity epidemic.1 Currently,the Obama administration has established the White House Taskforce on Childhood Obesity to develop and implement an inter-agency plan to tackle the problem. The goal of the action plan, including the First Lady’s “Let’s Move” program, is to reduce the childhood obesity rate to just 5% by 2030, the same rate before childhood obesity first began to rise in the late 1970’s.2 This program and taskforce must be proactive in reaching out to fitness professionals, schools, doctors, communities, and faith based organizations. Also, in the first major revision of school
meal standards in more than 15 years, the U.S. Department of Agriculture has recently implemented new rules that will boost the nutritional quality of the
meals eaten every day by school children.2 The family shapes child behavior and it is the most influential aspect of the young child’s immediate environment.6 Parents could influence their children’s physical activity by participating with them, encouraging them to be active, and taking them to places where they can be active. Population data shows that 16% of children and adolescents ages 2-19 do not meet any dietary recommendations and only 1% meets all commendations.6 Parents should plan, purchase, and prepare healthy meals and snack options more effectively and with more urgency. Healthy foods
don’t have to be more expensivw if parents use creative and smarter strategies such as incorporating leftovers into subsequent meals, buying in bulk, or buying
the cheaper store/generic brands. It is estimated that children in the U.S. are spending 25% of their waking hours watching television.6 Parents should turn off the televisions, computers, and cell phones and do their food and exercise decision-making out loud so that children clearly understand how choices are made.5
the unique biomechanical and physiological nature of children. Fitness professionals must reach out to their local communities, faith based organizations, and schools to offer their support, resources, and solutions for healthy kids. The fitness industry as a whole must work together more cohesively to set standards, hold poor performers accountable, and spotlight their service as an important solution to childhood obesity. The fitness industry must also continue to build strong relationships with the medical community and communicate more effectively with physicians and doctors. Physicians must be more aware of the clinical guidelines to helping combat childhood obesity including: to assess all children annually for weight status and body mass index for age, to evaluate dietary patterns and physical activity and sedentary behaviors at each well-child visit, to offer appropriate lifestyle messages to all children, and to deliver appropriate assessment, counseling, and treatment to children who are already overweight or obese.4 They must believe it’s more of a personal and ethical responsibility. Parents must adhere to any doctor recommendations of exercise prescription and understand the value of their investment in adopting a healthier for hemselves and their kids, whether it’s covered by their health insurance or not. More than 95% of all children and adolescents between the ages of 5 and 17 are enrolled in school.3 Since schools have continuous and intensive contact with youth during the first two decades of their lives, they must swiftly implement healthy lifestyle components into their curriculum. For instance, it can be designed in such a way that incorporates a portion of nutrition education into the core subjects. For example, students could learn about the number of calories and proportions of the food pyramid in math class, a daily food and activity journal could be utilized in a writing unit, and books about eating healthy could be used for reading assignments.3 Local, state, and federal governments must do more to provide incentives for healthy communities; such as parks, playgrounds, bike paths, and open spaces. They must encourage, recognize and support
community and civic groups such as Chamber of Commerce’s, Jaycees, Kiwanis, Rotary, etc. to run health promoting events such as local charity run walks,
fitness challenges, and health fairs. The federal government should implement a conditional spending grant that allows for schools to receive additional funding as an incentive for incorporating nutrition and exercise education into their curriculum. Conditional spending has proven to be an effective method of encouraging states to act.3 There should be more public health investigations into things such as soda, fast food, and other sectors of the food industry, and it must continue to be vigorous and expose and challenge the many ways the food industry creates a toxic environment that exploits children through targeted marketing and exacerbates the obesity epidemic.1 Currently,the Obama administration has established the White House Taskforce on Childhood Obesity to develop and implement an inter-agency plan to tackle the problem. The goal of the action plan, including the First Lady’s “Let’s Move” program, is to reduce the childhood obesity rate to just 5% by 2030, the same rate before childhood obesity first began to rise in the late 1970’s.2 This program and taskforce must be proactive in reaching out to fitness professionals, schools, doctors, communities, and faith based organizations. Also, in the first major revision of school
meal standards in more than 15 years, the U.S. Department of Agriculture has recently implemented new rules that will boost the nutritional quality of the
meals eaten every day by school children.2 The family shapes child behavior and it is the most influential aspect of the young child’s immediate environment.6 Parents could influence their children’s physical activity by participating with them, encouraging them to be active, and taking them to places where they can be active. Population data shows that 16% of children and adolescents ages 2-19 do not meet any dietary recommendations and only 1% meets all commendations.6 Parents should plan, purchase, and prepare healthy meals and snack options more effectively and with more urgency. Healthy foods
don’t have to be more expensivw if parents use creative and smarter strategies such as incorporating leftovers into subsequent meals, buying in bulk, or buying
the cheaper store/generic brands. It is estimated that children in the U.S. are spending 25% of their waking hours watching television.6 Parents should turn off the televisions, computers, and cell phones and do their food and exercise decision-making out loud so that children clearly understand how choices are made.5
In conclusion, with the joint efforts of governments, schools, fitness professionals, doctors, parents, and communities and faith based organizations, there is hope that the children of today and tomorrow can be just that: children. Happy, healthy, playful, curious, and optimistic young humans who can make their dreams and aspirations come true in a bright future. Everybody has a stake in battling childhood obesity, hopefully we can work together and all win.
References
1. Hayward, P. (2011). Let's move! gets moving. Parks & Recreation, 46(8), 21-22.
2. April 18, 2012, from http://www.letsmove.gov/
3. Lueke, L. (2011). Devouring childhood obesity by helping children help themselves. Journal Of Legal Medicine, 32(2), 205-220. doi:10.1080/01947648.2011.576621
4. Saxe, J. (2011). Promoting healthy lifestyles and decreasing childhood obesity: increasing physician effectiveness through advocacy. Annals
Of Family Medicine, 9(6), 546-548.
Of Family Medicine, 9(6), 546-548.
5. Williams, A. (2011). Childhood obesity dooms day countdown. IDEA Fitness Journal, 8(10), 48-57.
6. Williams, J. E. (2011). Child obesity in context: ecology of family and community. International Journal Of Exercise Science, 4(2), 86-92.
