| The Danger Of Overweight New studies confirm that too many children weigh too much, a situation that can have fatal results. Here's what you need to know. By Paige Egan (8/7/00) Once upon a time parents doted on kids with rolls of flesh like a Michelin tire man. It was "baby fat," a sign of hardy health. Today, however, the latest research shows that children who stay too fat risk serious, permanent damage to their health--even shortened life span. Several different government surveys done over a l0 year period reveal that we're living in the grips of an epidemic-many too many people, kids included, are overweight. Last year the Journal of the American Medical Association published a study with shocking results: 12-17% of adults and children in the US are "morbidly obese," meaning 6 million American children are fat enough to cause dangerous medical problems with another 5 million on the borderline. (To determine if your child is overweight, see Box at end of this article). If this trend continues, kids, warns the AMA, could join the half million Americans who die each year from fat-related diseases like diabetes, heart disease, high blood pressure and some cancers. Secretary of Agriculture Dan Glickman says obesity could one day equal smoking as our leading cause of preventable death. WHAT'S THE CAUSE? Are kids today just hungrier? Are their favorite foods loaded with fat, sugar and empty calories? Apparently it's the latter, exacerbated by the way we live in the digitized Millennium. Dr. Richard Gordon, clinical psychiatrist, professor at Bard College and author of "Eating Disorders: Anatomy of a Social Epidemic," (Blackwell, 2000) blames our current lifestyle. "We live in a terrible health ecology for two reasons: l. poor eating habits and--few home-cooked family meals, large portions of junk food; 2. sedentary lives with far too little physical exercise. It comes down to the old rule," says Gordon. "Calories In must equal Calories Out." Gordon's research found a direct correlation between the number of pounds a child or teen is overweight and the number of hours spent watching TV, surfing the Internet or playing Nintendo and other video games, not to mention listening to stereo, CD's, etc. "We know heredity determines how many fat cells we have in our bodies," Dr. Gordon explains, "but our culture is the cause of the problem today." School lunches may be healthy enough but kids fall under the spell of McDonald's and Burger King's cheap, gigantic meals and free toys and/or trendy paraphernalia. More and more kids skip lunch, graze on chips, candy bars and other fat-laden snacks available in the flashy vending machines all over our schools--waiting for an after-school raid on amusement park-style fast food emporiums. But what are these medical problems caused by overweight youngsters? Pediatricians now see fat children with physical damage of the type previously seen only in adults. For example, Type 2 Diabetes, was once a disease so rare in kids that pediatricians didn't bother screening for it during physical exams. Now, however, the Centers for Disease Control reports that 30% of pediatric patients with weight problems suffer from this grave condition. In fact, there are two types of diabetes--one far less serious than the other. Type l Diabetes means the pancreas can't produce enough insulin to do the job of carrying sugar (glucose) from the bloodstream to the cells (organs) of the body. Type 2 Diabetes, by far the more dangerous, means the person's cells build up a resistance to insulin so the conversion process it catalyzes doesn't work. Instead of delivering sugar to the cells on a regular, gradual basis, lack of insulin and/or insulin resistant cells causes excessive amount of sugar to accumulate in the bloodstream while the body's organs are starving for nutrients--and being damaged. If undiagnosed, Type 2 Diabetes causes irreparable damage to blood vessels and can lead to major kidney damage, heart attack, stroke, blindness and/or loss of limbs. An overweight child suffering from untreated Diabetes Type 2 for ten or less years will be very sick by adolescence. And diabetes isn't the only frightening consequence of chronic overweight in kids. Cardiovascular disease, heart attacks and strokes occur too. Pediatricians conducting a routine physical on children aged 3 or 4 have found precursor conditions like high blood pressure, elevated cholesterol, even fatty liver, an early stage of permanent liver damage. Left unchecked, routine indulgence in high calorie, high fat junk food and sugary drinks with caffeine will, say nutritionists and doctors, produce a generation of young arteriosclerosis and renal failure victims within 20 years. Physical damage of this kind to the organ systems of a young body may be permanent. WHAT YOU CAN DO There is much you as a parent can do to assure that none of these consequences befall your child. First, find a highly recommended pediatrician--not a general practitioner or your own doctor. As soon as your child has been examined and evaluated, Dr. Richard Gordon says, weight loss goals can be set and common-sense changes made in the family's routine. "Obesity is a family disease," he stresses. Above all, parents must not be punitive or show disapproval. Dr. Gordon says to be loving, supportive, constructive and take an active role in the crisis your youngster faces. "There's nothing wrong with setting limits to help alter a child'' mind set," he urges, mentioning that his work with fat kids and their families has shown that parents with demanding careers may compensate for their absence by being overly permissive. And free time with lack of structure contributes to couch potato mode. "Structuring after school and weekend time is important," states Gordon. "Limit TV or computer. Some parents eliminate TV. Replace solitary, sedentary activity with physical activity." Simple as it may sound, Dr. Gordon finds that taking up a family sport is an enormous help to overweight kids who welcome not only the sport but bask in the extra attention from dad and/or mom. "Assert yourselves and make it fun," he suggest, "Walk up stairs to the museum, take up serious biking, hiking, nature walks, golfing, tennis, or use home work-out equipment like a stair master, treadmill or exercycle. I advise parents to involve their kids in physical activity from an early age--before a problem arises." As for eating habits, Dr. Gordon reminds parents that they are the adults--that the food kept and served in the home is their prerogative. He suggests switching to low calorie items: replace bags of Cheetos, Potato Chips or sugary cereals with dried fruit or with fresh fruit washed and ready to eat in the refrigerator. Instead of soft drinks substitute mineral water with flavors, sugar-free drinks and/or skim milk flavored with chocolate or strawberry prepared in advance. "Limits can be set about food as well as exercise and entertainment," says Gordon. "Be sparing with pocket money that might be spent on Dunkin' Donuts or the Carvel stand." Meals can be planned later so the family eats together and cooking can be an enjoyable group effort. Above all, say nutritionists and other medical professionals, parents need to lovingly guide their child back to good health. These alarming studies are a warning to us all. We adults must make the world beneficial place for our children. IS YOUR CHILD OVERWEIGHT? Do's and Don'ts Don'ts 1..Don't act impulsively. Be aware that a chubby phase which often accompanies or precedes a growth spurt may not be a medical overweight problem. Wait for a few months. Then, if you're still concerned, take your child to a friendly well-recommended pediatrician your child will feel comfortable with. 2.Don't dismiss "baby fat" as harmless. Overweight 4 or 5 year olds may need help. 3. Don't abruptly start to ration food or snacks. Take the child to a pediatrician and get advice before making any changes. 4. Don't assume that chubby girls have more of a problem than chubby boys. Studies show boys with chronic weight problems and/or eating disorders are on the increase. 5. Don't force your child to exercise or institute family exercise rules until she or he has been diagnosed and tested. Don't make fat jokes or be judgmental. Emotional problems can exacerbate the situation. Do's 1. Keep a chart and/or take notes on the weight gain, its duration and circumstances. This will help the doctor. 2. Do some research at your child's school. Ask the dietician to explain the lunch and/or snack menu. Find out if food vending machines are available to kids and check out what they offer. 3. Talk to the physical education department. What exactly does your child during gym. Some schools have minimized or even eliminated gym or outdoor sports. 4. Check to see if any major change occurred in your family in the past year or so (or before the onset of the child's overweight). Changes include death of a relative or pet, divorce or separation, moving to a new town, loss of a child's friends, favorite teacher. 5. When visiting the pediatrician or doctor, leave your kids alone with the doctor. It doesn't help to hover. Your scrutiny may impede an honest assessment of the situation. And be sure to request a BMI (below). It's not the Pounds It's the BMI One of the major studies used to show the current overweight trend in children was the National Health and Nutritional Examination Survey, also called NAMES, done by the National Institute of Health. It determined a dramatic increase in kids' BMI or Body Mass Index between the years l980-l990 not counting the 7% of the population already classified as dangerously overweight. In l980, the average child's BMI was 20%. By l990, it had risen to 25-30%, considered high risk. Body Mass Index or BMI is the height to weight ratio for each age range and sex. It shows whether the child is overweight given age, height and body frame and is a much more accurate measurement of weight problems. Your doctor will calculate the child's BMI during a physical exam.
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