The Roots of Childhood Obesity

While the childhood obesity problem is deeply rooted, complicated and growing with each passing year, one expert urges policymakers and health professionals to take heart.

Each in his or her own way can make a difference, she says.

“You have a sphere of influence — people listen to you,” said Dr. Jeanette Endres, a professor emeritus in Southern Illinois University’s Department of Animal Science and Food Nutrition, speaking at the 7th Annual Diabetes and Obesity Conference in Prattville, sponsored by the Alabama Cooperative Extension System.

That’s important, Endres says, because a number of factors within this sphere of influence have changed radically since the 1990s.

The types of foods bought in the grocery stored have changed compared with a decade ago. Super-sizing also is more common than ever. And more parents than ever before are basing their food choices on their children’s eating preferences.

Even schools, despite their best efforts, also are partly responsible, Endres says. For example, even though the U.S. Department of Agriculture’s School Meal Initiative Program was established to ensure that schools better complied with the USDA’s dietary guidelines, only 5 percent of the nation’s schools currently meet these national nutritional standards.

And there’s a reason for this, Endres says.

“The more meals eaten, the more money is made to run the school lunch program,” she says.

Home influences also play a role. School children often are influenced by what they eat in the home — poor nutritional choices that often end up being reflected in school lunch programs. And these influences provide many, if not most, schools, with a strong incentive to serve schoolchildren the things they typically prize the most — hamburgers, pizza and chicken nuggets.

Adding to the problem is the growing number of schools that are de-emphasizing recess or phasing it out entirely, she says.

Endres also sights the growing effectiveness of sales and marketing techniques as a major contributor to obesity.

Many schools also are heavily dependent on the money provided by vending machine companies and aren’t willing to forego this source of money, despite the strong link between sweetened vending machine beverages and spiking rates of obesity.

Despite the complexity associated with obesity, Endres says health professionals never should lose sight of the role they can serve even as individuals to address the problem.

“Ask yourself if you’re doing everything you can to stop obesity in your community — that’s the bottom line,” says Endres, who also stresses that a big part of the success of any effort is bound up in communitywide efforts.

“You can’t do it by yourself,” she says. “It must involve community.”

And much of the success of this effort is bound up in choice of strategy and how well this is accessed and revised over time.

A good place to start, she says, is a coordinated school health program that encompasses both nutrition and physical activity.

“That includes everything the school does,” Endres says.

Endres, who has charted the growth of childhood obesity over the past couple of decades, says the problem is big and getting even bigger. As recently as 1987, the obesity rate among Illinois school children was running at around 10 percent — a percentage that increased to 15 percent in several states, including Alabama, in 1991.

But the problem was not yet on the radar of Endres and other health professionals and policymakers. Issues such as iron deficiency and anemia and even underweight children were still bigger issues back then, she says. And despite the spikes in obesity rates in some states, the overall national average still stood around 10 percent.

But between 1991 and 1996, things changed — radically in some parts of the country, as type II diabetes cases began to rise, Endres recalls.

“I worked with Head Start Children for many years and we never saw diabetes,” she says, adding that between 1982 and 1992 the percentage of children with type II diabetes rose from 4 percent to 16 percent, according to one study.

“The problem is real, the problem is large and the problem is serious.”

And for the vast majority of children, obesity is not a problem of baby fat that disappears with the onset of adulthood. Some 70 percent of obese children end up obese adults. Additionally, large-scale studies show a strong link between a high body-mass ratio in childhood and high lipid rates of hypertension in adulthood.

Endres says she still is amazed to see hypertensive children — something exceedingly rare only a few decades ago.

Posted by Jim Langcuster at April 7, 2008 10:06 AM